Individual provider Active NPI

Kate Emma Weathersbee, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1023743911
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA8854 Issued in MA
Practice address
1 Boston Medical Ctr PL
BCD 1St FL
Boston, MA 02118-2908
Phone
(617) 414-5481
Fax
(617) 414-7759
NPI assigned
Jul 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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 PA8854 MA Primary

Addresses

Primary practice location

1 Boston Medical Ctr PL
BCD 1St FL
Boston, MA 02118-2908

Mailing address

960 Massachusetts Avenue
FL 2
Boston, MA 02118-2690

Other identifiers 2

IdentifierTypeStateIssuer
3138941MedicaidNH
110189343AMedicaidMA

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
I20221214001931 MA Practitioner - Physician Assistant 3072982073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1019 Trapelo Rd
Waltham, MA 02452-5002
Phone (774) 400-4084

1030 Main St
Waltham, MA 02451-7447
Phone (781) 894-6900

1210 Boylston St
Chestnut Hill, MA 02467-2109
Phone (774) 400-4084

154 Great Rd
Bedford, MA 01730-2725
Phone (781) 430-8161

16 Main St
Stoneham, MA 02180-3334
Phone (781) 279-4000

17 White St
Cambridge, MA 02140-1413
Phone (781) 430-9161

4110 Mystic Valley Pkwy
Suite 2
Medford, MA 02155-6916
Phone (774) 400-4084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA8854MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Patriot Urgent Care Professionals PC CurrentSince Feb 1, 2025 Accepting new patients
Patriot Urgent Care Professionals PC CurrentSince Feb 1, 2025 Accepting new patients

Locations

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

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

Organizations & group practices 4

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": "1658534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1023743911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVENUE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOSTON MEDICAL CTR PL",
            "address_2": "BCD 1ST FL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182908",
            "telephone_number": "617-414-5481",
            "fax_number": "617-414-7759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERSBEE",
        "first_name": "KATE",
        "middle_name": "EMMA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-23",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA8854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3138941",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110189343A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.