Individual provider Active NPI

Danielle Boley, PAC

  • Physician Assistant
  • Rocky Hill, CT
National Provider Identifier
1134571284
Registry record updated Mar 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1111 Cromwell Ave
Rocky Hill, CT 06067-3449
Phone
(860) 525-4469
NPI assigned
Jul 12, 2016
Last updated
Mar 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2022

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 Primary

Addresses

Primary practice location

1111 Cromwell Ave
Rocky Hill, CT 06067-3449

Mailing address

62 Rosewood Dr
Glastonbury, CT 06033-1647
Phone (774) 230-2500

Other practice location 1

512 Saybrook Rd
100
Middletown, CT 06457-4788
Phone (860) 704-6021

Other practice location 2

810 Mitchell Ave
Salisbury, NC 28144
Phone (704) 216-5633

Other practice location 3

810 Mitchell Ave
Salisbury, NC 28144
Phone (704) 216-5633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20160920002249 CT Practitioner - Physician Assistant 0941597827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1111 Cromwell Ave
Suite 404
Rocky Hill, CT 06067-3455
Phone (860) 525-4469

277 Middle Tpke W
Manchester, CT 06040-3834
Phone (860) 432-4640

31 Ensign Dr
Avon, CT 06001-3773
Phone (860) 525-4469

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3614CTMDRespiratory/Developmental/Rehabilitative Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Surgical Partners, PC CurrentSince Apr 1, 2022 Accepting new patients
Orthopedic Surgical Partners, P.C. Physician Assistant CurrentSince Apr 1, 2022 Accepting new patients

Locations

31 Ensign Dr
Avon, CT 06001
Phone (860) 409-9125

277 Middle Tpke W
Manchester, CT 06040
Phone (860) 432-4640

1111 Cromwell Ave
Ste 403
Rocky Hill, CT 06067

1111 Cromwell Ave
Ste 404
Rocky Hill, CT 06067
Phone 8605254469112

5 Founders St
Ste 202
Willimantic, CT 06226
Phone (860) 456-3997

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647734400000",
    "number": "1134571284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 ROSEWOOD DR",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331647",
            "telephone_number": "774-230-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 CROMWELL AVE",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060673449",
            "telephone_number": "860-525-4469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "512 Saybrook Rd",
            "address_2": "100",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "CT",
            "postal_code": "064574788",
            "country_code": "US",
            "telephone_number": "860-704-6021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "810 Mitchell Ave",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "28144",
            "country_code": "US",
            "telephone_number": "704-216-5633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "810 Mitchell Ave",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "28144",
            "country_code": "US",
            "telephone_number": "704-216-5633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLEY",
        "first_name": "DANIELLE",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-12",
        "last_updated": "2022-03-20",
        "certification_date": "2022-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Hill, CT

Sources for this page

Verify at the official NPI Registry.