Individual provider Active NPI

Allison R Rogers, PA

  • Pediatrics Physician
  • Chestnut Hill, MA
National Provider Identifier
1134866775
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
PA100464 Issued in MA
Practice address
291 Independence Dr
Chestnut Hill, MA 02467-3628
Phone
(617) 541-6400
Fax
(617) 541-6441
NPI assigned
May 16, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X PA100464 MA Primary

Addresses

Primary practice location

291 Independence Dr
Chestnut Hill, MA 02467-3628

Mailing address

291 Independence Dr
Chestnut Hill, MA 02467-3628
Phone (617) 541-6400

Other names 1

  • Allison Ruth Avery Former name

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
I20241108003038 MA Practitioner - Physician Assistant 6608300918

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Pediatrics CurrentSince Nov 4, 2024 Accepting new patients
Atrius Health, Inc. CurrentSince Nov 4, 2024 Accepting new patients
Bridgewater Pediatrics LLC Pediatrics Past Accepting new patients

Locations

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

291 Independence Dr
Chestnut Hill, MA 02467
Phone (617) 325-2800

Interoperability endpoints

  • Direct secure messaging: arogers40757@direct.chppoc.masshiway.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1134866775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 INDEPENDENCE DR",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024673628",
            "telephone_number": "617-541-6400",
            "fax_number": "617-541-6441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 INDEPENDENCE DR",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024673628",
            "telephone_number": "617-541-6400",
            "fax_number": "617-541-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "ALLISON",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-16",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "PA100464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLISON",
            "last_name": "AVERY",
            "middle_name": "RUTH",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chestnut Hill, MA

Sources for this page

Verify at the official NPI Registry.