Individual provider Active NPI

Nyaradzo Prisca Munjanja, PA-C

  • Physician Assistant
  • Cambridge, MA
National Provider Identifier
1033474333
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9579 Issued in MA
Practice address
1400 Cambridge St
Cambridge, MA 02139-1105
Phone
(617) 714-4534
Fax
(617) 714-4962
NPI assigned
Jul 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085007410 IL
Physician Assistant 363A00000X 015712 NY
Physician Assistant 363A00000X PA9579 MA Primary

Addresses

Primary practice location

1400 Cambridge St
Cambridge, MA 02139-1105

Mailing address

10 Ferry St Ste 302
Concord, NH 03301-5081
Phone (603) 526-4635

Other practice location 1

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-3718

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
I20230914000436 MA Practitioner - Physician Assistant 6305094848 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10 Ferry St
Suite 302
Concord, NH 03301-5004

45 Spring St
Apt 8
West Roxbury, MA 02132-3901

62 13RH St
Charlestown, MA 02129-2056

Hospital & facility affiliations

  • Mount Auburn Hospital Hospital, Cambridge, MA, CCN 220002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9579MAMDPhysician Assistant
015712NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carewell Urgent Care Centers of Ma, P.C CurrentSince Aug 29, 2023 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Dec 15, 2025 Accepting new patients
The General Hospital Corporation CurrentSince Dec 15, 2025 Accepting new patients
Urgent Care Centers of Central Massachusetts, LLC CurrentSince Aug 29, 2023 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

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

757 Boston Post Rd E
Marlborough, MA 01752
Phone (508) 630-8989

484 Route 134
South Dennis, MA 02660
Phone (508) 694-7901

10 Ferry St
Ste 302
Concord, NH 03301

Interoperability endpoints

  • Direct secure messaging: ntsemunhumd306201@carlehiedirect.net

Organizations & group practices 5

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 1

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": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1033474333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 FERRY ST STE 302",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033015081",
            "telephone_number": "603-526-4635",
            "fax_number": "603-526-8283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 CAMBRIDGE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391105",
            "telephone_number": "617-714-4534",
            "fax_number": "617-714-4962"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142696",
            "country_code": "US",
            "telephone_number": "617-724-3718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNJANJA",
        "first_name": "NYARADZO",
        "middle_name": "PRISCA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-12",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007410",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015712",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA9579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.