NPIMap

Individual provider Active NPI

Giselle Tungol, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1104316314
Registry record updated May 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA6473 Issued in MA
Practice address
55 Fruit St
Blake 1500
Boston, MA 02114
Phone
(617) 724-3874
NPI assigned
May 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2018

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 PA6473 MA Primary

Addresses

Primary practice location

55 Fruit St
Blake 1500
Boston, MA 02114

Mailing address

55 Fruit St
Blake 1500
Boston, MA 02114
Phone (617) 721-3874

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210610001373 CO Practitioner - Physician Assistant 8527310218 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Imaging Associates P CGroup PAC ID 6800880055, 61 clinicians
Colorado Advanced Endovascular, LLCGroup PAC ID 7416485008, 13 clinicians

Practice addresses (Care Compare)

11600 W 2ND PL
Lakewood, CO 80228-1527
Phone (303) 433-9729

11650 W 2ND PL
Lakewood, CO 80228-1527
Phone (303) 433-9729

14300 Orchard Pkwy
Westminster, CO 80023-9206
Phone (720) 627-3180

355 Union Blvd
Suite 100
Lakewood, CO 80228-1500
Phone (720) 669-3036

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.64 of 100Reported as group
Quality
86.81
Improvement activities
40
Cost
77.34

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: coloradoadvancedendovascular.giselletungol@159105.advancedmd-direct.com

Organizations & group practices 2

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 10

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": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1104316314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "BLAKE 1500",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-721-3874",
            "fax_number": "617-643-1781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "BLAKE 1500",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-724-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUNGOL",
        "first_name": "GISELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-14",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA6473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.