Alissa Bologna Siciliano, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2318 Issued in MA

Practice address

725 Albany St
Shapiro 3, Suite B
Boston, MA 02118-2526

Phone

(617) 638-8485

Fax

(617) 414-7372

NPI assigned

May 3, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

South Shore Medical Center, Inc.Group PAC ID 3678487444, 174 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South Shore Hospital Hospital, South Weymouth, MA, CCN 220100

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• South Shore Medical Center, Inc.

  • Internal Medicine Physician
  • Norwell, MA
  • NPI 1669411856
  Medicare reassignment Care Compare group
• Steward Medical Group, Inc

  • Specialist
  • Watertown, MA
  • NPI 1629398219
  Medicare reassignment NPD
• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Shore Hospital Inc.

  • General Acute Care Hospital
  • South Weymouth, MA
  • NPI 1134227606
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1104048362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY ST",
            "address_2": "SHAPIRO 3, SUITE B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182526",
            "telephone_number": "617-638-8485",
            "fax_number": "617-414-7372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "780 Main St Ste 2C",
            "address_purpose": "LOCATION",
            "city": "Weymouth",
            "state": "MA",
            "postal_code": "021901618",
            "country_code": "US",
            "telephone_number": "781-331-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SICILIANO",
        "first_name": "ALISSA",
        "middle_name": "BOLOGNA",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA2318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Jean Sicard
• Molly Sicchio, MS, RN, CPNP
• Joseph Sidney Sichel, MD
• Elena Sicilia Blanco
• Leonard Sicilian, MD
• Meagan Siciliano
• Melissa Siciliano, CPHT
• Stencia Sickey, LICSW
• Laurie Sickles, RN
• Faten Sid Idris, MD

• Physician Assistant in Boston, MA
• Providers in Boston, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.

Verify at the official NPI Registry.