Individual provider Active NPI

Michaela Smith

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1013760131
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
179 Longwood Ave
Boston, MA 02115-5804
Phone
(617) 731-2918
NPI assigned
Apr 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Physician Assistant 363A00000X PA100881 MA

Addresses

Primary practice location

179 Longwood Ave
Boston, MA 02115-5804

Mailing address

179 Longwood Ave
Boston, MA 02115-5804
Phone (617) 731-2918

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
I20241205002287 MA Practitioner - Physician Assistant 6507392172 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians of Falmouth HospitalGroup PAC ID 6800051970, 92 clinicians
Medical Affiliates of Cape Cod IncGroup PAC ID 3577471564, 237 clinicians

Practice addresses (Care Compare)

100 Ter Heun Dr
Falmouth, MA 02540-2503
Phone (508) 771-1800

184 Ter Heun Dr
Falmouth, MA 02540-2503
Phone (508) 457-4621

21 Bramble Bush Dr
Falmouth, MA 02540-2325
Phone (508) 495-5160

27 Park St
Hyannis, MA 02601-5230
Phone (508) 771-1800

5 Bramble Bush Dr
Falmouth, MA 02540-2325
Phone (508) 495-8300

90 Ter Heun Dr
Falmouth, MA 02540-2533
Phone (508) 774-3205

Hospital & facility affiliations

  • Falmouth Hospital Hospital, Falmouth, MA, CCN 220135
  • Cape Cod Hospital Hospital, Hyannis, MA, CCN 220012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA100881MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Affiliates of Cape Cod, Inc. CurrentSince Oct 28, 2024 Accepting new patients

Locations

21 Bramble Bush Dr
Falmouth, MA 02540
Phone (508) 495-5160

5 Bramble Bush Dr
Falmouth, MA 02540
Phone (508) 495-8300

297 North St
Ste 221
Hyannis, MA 02601
Phone (508) 862-5032

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1712620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1013760131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155804",
            "telephone_number": "617-731-2918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155804",
            "telephone_number": "617-731-2918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA100881",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.