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MIKAYLA MARIE VAN DERVOORT PA-C
NPI 1649014614
Physician Assistant in Saugus, MA

Active since June 24, 2024PECOS EnrolledAccepts Medicare Assignment
180 MAIN ST, SAUGUS, MA 01906(339) 674-0978(339) 574-0914 Get Directions Write a Review

NPPES record last updated: September 16, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 16, 2024, Jun 24, 2024 (2 updates tracked since 2024).

About Mikayla Marie Van Dervoort Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIKAYLA MARIE VAN DERVOORT PA-C (NPI 1649014614) is an individual physician assistant in Saugus, Massachusetts and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS, is affiliated with Tufts Medical Center, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1649014614
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMIKAYLA MARIE VAN DERVOORTCredential: PA-C
Location Address180 MAIN STSaugus, MA 01906-3213
Mailing Address360 Us Highway 1 Byp Unit 102Portsmouth, NH 03801-7105 · (603) 410-6700 · Fax (603) 309-8308
Phone(339) 674-0978
Fax(339) 574-0914
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateJune 24, 2024
Last NPPES UpdateSeptember 16, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2024
✔ NPI 1649014614 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
180 MAIN ST, Saugus, MA 01906
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mikayla Marie Van Dervoort Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739620659
PECOS Enrollment IDI20240919000427
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
19 services19 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
14 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Tufts Medical Center

Acute Care Hospitals · Boston, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220116
Location800 Washington StreetBoston, MA 02111 · Suffolk County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01906 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.70 typical visit price
range $58.86 – $177.36
Typical copayment $22.67 (range $14.71 – $44.34)
Most-billed visit code 99203
Established Patient
$73.22 typical visit price
range $19.11 – $144.84
Typical copayment $18.30 (range $4.77 – $36.21)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CONVENIENTMD - FFS UC LLC
Clinic/Center (Urgent Care)
180 MAIN ST
SAUGUS, MA 01906
Essex County (339) 674-0914
CONVENIENTMD LLC
Clinic/Center (Urgent Care)
180 MAIN ST
SAUGUS, MA 01906
Essex County (339) 674-0978

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mikayla Van Dervoort's NPI number?

The NPI number for Mikayla Van Dervoort is 1649014614. It was assigned to this individual provider in the NPPES registry on June 24, 2024.

Where is Mikayla Van Dervoort located?

Mikayla Van Dervoort practices at 180 Main St, Saugus, MA 01906. The listed phone number is (339) 674-0978.

What is Mikayla Van Dervoort's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Mikayla Van Dervoort enrolled in Medicare?

Yes. Mikayla Van Dervoort is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Mikayla Van Dervoort affiliated with any hospitals?

According to CMS data, Mikayla Van Dervoort is affiliated with Tufts Medical Center.

When was this NPI record last updated?

The NPPES record for Mikayla Van Dervoort was last updated on September 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.