Individual provider Active NPI

Andrew Simon Baylouny, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1114665429
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9255 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 726-2784
NPI assigned
May 25, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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
Physician Assistant 363A00000X PA9255 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

62 13TH St
Charlestown, MA 02129-2056
Phone (617) 724-4133

Other practice location 1

245 Hartford Ave
Bellingham, MA 02019-3007
Phone (774) 295-4355

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
I20230307003154 MA Practitioner - Physician Assistant 7517330897 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc CurrentSince Oct 10, 2024 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Aug 26, 2023 Accepting new patients
General Hospital Corp Current Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Aug 26, 2023 Accepting new patients
Convenientmd LLC Past Accepting new patients
Convenientmd - FFS UC LLC Past Accepting new patients

Locations

245 Hartford Ave
Ste 1
Bellingham, MA 02019
Phone (774) 295-4355

245 Hartford Ave
Bellingham, MA 02019
Phone (774) 295-4355

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

55 Fruit St
Boston, MA 02114

62 13th St
Charlestown, MA 02129
Phone (617) 724-3874

40 Davis Straits
Falmouth, MA 02540
Phone (774) 255-3010

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

Interoperability endpoints

  • Direct secure messaging: baylouny.andrew.mgh@direct.partners.masshiway.net

Organizations & group practices 8

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": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1114665429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 13TH ST",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021292056",
            "telephone_number": "617-724-4133",
            "fax_number": "617-643-7941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-2784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 Hartford Ave",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "MA",
            "postal_code": "020193007",
            "country_code": "US",
            "telephone_number": "774-295-4355",
            "fax_number": "774-295-4880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAYLOUNY",
        "first_name": "ANDREW",
        "middle_name": "SIMON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-25",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA9255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.