Individual provider Active NPI

Samantha Villa, MPAS

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1073237152
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
100046 Issued in MA
Practice address
275 Cambridge St
Boston, MA 02114-3108
Phone
(617) 726-2000
NPI assigned
Oct 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 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 100046 MA Primary

Addresses

Primary practice location

275 Cambridge St
Boston, MA 02114-3108

Mailing address

10 Wallingford Rd
Brighton, MA 02135-4702
Phone (317) 965-5444

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
I20231206001075 MA Practitioner - Physician Assistant 7315396181 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100046MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Jan 8, 2024 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

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

275 Cambridge St
Boston, MA 02114
Phone (617) 724-6640

Interoperability endpoints

  • Direct secure messaging: villa.samantha.mgh@direct.partners.masshiway.net

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 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": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1073237152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WALLINGFORD RD",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021354702",
            "telephone_number": "317-965-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 CAMBRIDGE ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143108",
            "telephone_number": "617-726-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLA",
        "first_name": "SAMANTHA",
        "credential": "MPAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "100046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.