Active NPI
Adriana A Penicaud, PAC
- Physician Assistant
- Boston, MA
National Provider Identifier
1144271438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2042
- Practice address
- 44 Binney St
D1B30
Boston, MA 02115-6013 - Phone
- (617) 582-8423
- NPI assigned
- May 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2042 | MA | Primary |
Addresses
Primary practice location
44 Binney St
D1B30
Boston, MA 02115-6013
Mailing address
44 Binney St
D1B30
Boston, MA 02115-6013
Phone (617) 582-8423
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2042 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187222400000",
"number": "1144271438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 BINNEY ST",
"address_2": "D1B30",
"city": "BOSTON",
"state": "MA",
"postal_code": "021156013",
"telephone_number": "617-582-8423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 BINNEY ST",
"address_2": "D1B30",
"city": "BOSTON",
"state": "MA",
"postal_code": "021156013",
"telephone_number": "617-582-8423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENICAUD",
"first_name": "ADRIANA",
"middle_name": "A",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-12",
"last_updated": "2007-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "2042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.