Active NPI
Laticco R Robinson, PA-C
- Physician Assistant
- Boston, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA4874
- Practice address
- 830 Harrison Avenue, 3Rd FL
Moakley BLDG
Boston, MA 02118-2905 - Phone
- (617) 638-6428
- Fax
- (617) 638-5756
- NPI assigned
- Oct 30, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA4874 | MA | Primary |
Addresses
Primary practice location
830 Harrison Avenue, 3Rd FL
Moakley BLDG
Boston, MA 02118-2905
Mailing address
960 Massachusetts Ave
FL 2
Boston, MA 02118
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110108068A | Medicaid | MA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pratt Medical Group, Inc | Current | Accepting new patients | |
| Pratt Medical Group, Inc | Current | Accepting new patients | |
| Pratt Medical Group, Inc | Past | Accepting new patients | |
| Boston University General Surgical Associates, Inc.-QMC | Past | Accepting new patients |
Locations
800 Washington St
#1
Boston, MA 02111
800 Washington St
Boston, MA 02111
Phone (617) 636-4800
Interoperability endpoints
- lrobinson29736@tuftsmedicine.direct-ci.com
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.
-
dba Pratt Medical Group, Inc-General Medical Associates
- Internal Medicine Physician
- Boston, MA
- NPI 1275570319
-
dba Pratt Medical Group, Inc - Nephrology
- Nephrology Physician
- Boston, MA
- NPI 1164743209
-
dba Pratt Medical Group, Inc - Pulmonary Disease
- Pulmonary Disease Physician
- Boston, MA
- NPI 1508187642
-
- Podiatrist
- Quincy, MA
- NPI 1396041356
-
dba Pratt Orthopaedics Associates, Inc
- Orthopaedic Surgery Physician
- Boston, MA
- NPI 1184661225
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Tufts Medical Center
- General Acute Care Hospital
- Boston, MA
- NPI 1730132515
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784764800000",
"number": "1093143026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "960 MASSACHUSETTS AVE",
"address_2": "FL 2",
"city": "BOSTON",
"state": "MA",
"postal_code": "02118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 HARRISON AVENUE, 3RD FL",
"address_2": "MOAKLEY BLDG",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182905",
"telephone_number": "617-638-6428",
"fax_number": "617-638-5756"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBINSON",
"first_name": "LATICCO",
"middle_name": "R",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-10-30",
"last_updated": "2026-07-23",
"certification_date": "2026-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "PA4874",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110108068A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.