NPIMap

Individual provider Active NPI

Amy Simmons, PA-C

  • Physician Assistant
  • Wilmington, MA
National Provider Identifier
1033597075
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA7515 Issued in MA
Practice address
168 Woburn St
Wilmington, MA 01887-1478
Phone
(978) 228-9661
NPI assigned
May 11, 2015
Last updated
Aug 26, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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 018526-1 NY
Physician Assistant 363A00000X PA7515 MA Primary

Addresses

Primary practice location

168 Woburn St
Wilmington, MA 01887-1478

Mailing address

168 Woburn St
Wilmington, MA 01887-1478
Phone (978) 228-9661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160122002088 NY Practitioner - Physician Assistant 9739482811 Reassigns benefits to 2 organizations
I20201007003001 MA Practitioner - Physician Assistant 9739482811 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 739-6950

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018526NYMDRehabilitation Psychologist
PA7515MAMDPhysician Assistant
018526-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Dec 4, 2017 Accepting new patients
Patriot Urgent Care Professionals PC CurrentSince Aug 1, 2020 Accepting new patients
New York University CurrentSince Dec 4, 2017 Accepting new patients
Patriot Urgent Care Professionals, PC CurrentSince Aug 1, 2020 Accepting new patients
Trustees of Columbia University in the City of New York Physician Assistant CurrentSince Aug 1, 2018 Accepting new patients
North Shore Medical Center, Inc. Current Accepting new patients

Locations

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

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

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

622 W 168th St
Ph 1137
New York, NY 10032
Phone (212) 305-2575

630 W 168th St
New York, NY 10032
Phone (212) 305-1948

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: simmons.amy.nsmc@direct.partners.masshiway.net

Organizations & group practices 9

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

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": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1033597075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 WOBURN ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018871478",
            "telephone_number": "978-228-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 WOBURN ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018871478",
            "telephone_number": "978-228-9661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "AMY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-11",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018526-1",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA7515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, MA

Sources for this page

Verify at the official NPI Registry.