GARDNER FAMILY MEDICINE, INC. – Physician Assistant, NPI 1003011594

GARDNER FAMILY MEDICINE, INC. is a healthcare provider. based in Gardner, Massachusetts. specializing in Physician Assistant. The organization holds a License No. 2141244 (MA). The NPI Number for GARDNER FAMILY MEDICINE, INC. is 1003011594

Main info

Organization
Name
GARDNER FAMILY MEDICINE, INC.
NPI
1003011594
Phone
(978) 630-3862
Address
57 CITY HALL AVE
Authorized Official
JENNIFER RYAN PRESIDENT DO
Enumeration Date
15 June 2007
Last Update Date
11 September 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness85
Years active:18State licenses:2Digital endpointsOther names

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Provider Addresses for GARDNER FAMILY MEDICINE, INC.

  • Levi Heywood Memorial Library, 57, City Hall Avenue, Gardner, Worcester County, Massachusetts, 01440, United States

    GARDNER, MA 014402614

    Phone: (978) 630-3862

    Fax: (978) 630-4176

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-10-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20071022000189OClinic/Group PracticeMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 01440)

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Reviews

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Frequently asked questions

What is GARDNER FAMILY MEDICINE, INC.'s NPI number?
GARDNER FAMILY MEDICINE, INC.'s NPI is 1003011594 — the number used across U.S. healthcare to identify this provider.
Is GARDNER FAMILY MEDICINE, INC. shown as active in public data?
Registry records indicate GARDNER FAMILY MEDICINE, INC. maintains an active NPI.
What kind of doctor is GARDNER FAMILY MEDICINE, INC.?
GARDNER FAMILY MEDICINE, INC. is associated with Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
Where in Massachusetts is GARDNER FAMILY MEDICINE, INC. registered?
Use Gardner, Massachusetts as the headline location for GARDNER FAMILY MEDICINE, INC. here.
Can I trust this NPI listing for GARDNER FAMILY MEDICINE, INC.?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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