Individual provider Active NPI

Mark Branton, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1003455940
Registry record updated Aug 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
55 Fruit St
Boston, MA 02114-2696
Phone
(617) 726-7400
NPI assigned
Dec 23, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2696

Mailing address

24 Standish Ave
Whitman, MA 02382-1508
Phone (609) 516-9496

Other practice location 1

55 Fogg Rd
Weymouth, MA 02190-2455
Phone (609) 516-9496

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200521002365 MA Practitioner - Physician Assistant 5092812495 Reassigns benefits to 7 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Patriot Urgent Care Professionals PC CurrentSince May 1, 2020 Accepting new patients
General Hospital Corp Current Accepting new patients
Lahey Clinic, Inc. CurrentSince Jun 3, 2021 Accepting new patients
Lahey Clinic, Inc CurrentSince Jun 3, 2021 Accepting new patients
Patriot Urgent Care Professionals, PC CurrentSince May 1, 2020 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Jun 27, 2024 Accepting new patients

Locations

154 Great Rd
Bedford, MA 01730
Phone (781) 430-8161

75 Francis St
Boston, MA 02115

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
Boston, MA 02114

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

67 S Bedford St
Burlington, MA 01803
Phone (781) 744-5115

1030 Main St
Waltham, MA 02451
Phone (781) 894-6900

Interoperability endpoints

  • Direct secure messaging: branton.mark.mgh@direct.partners.masshiway.net

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724457600000",
    "number": "1003455940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 STANDISH AVE",
            "city": "WHITMAN",
            "state": "MA",
            "postal_code": "023821508",
            "telephone_number": "609-516-9496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-726-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fogg Rd",
            "address_purpose": "LOCATION",
            "city": "Weymouth",
            "state": "MA",
            "postal_code": "021902455",
            "country_code": "US",
            "telephone_number": "609-516-9496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANTON",
        "first_name": "MARK",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-23",
        "last_updated": "2024-08-24",
        "certification_date": "2024-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.