Individual provider Active NPI

Mary N Kirya, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1144950593
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA8777 Issued in MA
Practice address
725 Albany Street, Suite 4B
Shapiro BLDG
Boston, MA 02118
Phone
(617) 638-5633
NPI assigned
Jun 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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 PA8777 MA Primary

Addresses

Primary practice location

725 Albany Street, Suite 4B
Shapiro BLDG
Boston, MA 02118

Mailing address

960 Massachusetts Ave
FL 2
Boston, MA 02118

Other practice location 1

100 Powdermill Rd
Acton, MA 01720-5932
Phone (978) 234-6497

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
I20220914000410 MA Practitioner - Physician Assistant 1355726290 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of California, Davis School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boston University Orthopaedic Surgical Associates IncGroup PAC ID 0143297655, 36 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-5633

725 Albany St
Boston, MA 02118-2526
Phone (617) 638-5633

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Patriot Urgent Care Professionals PC CurrentSince Jul 25, 2022 Accepting new patients
Patriot Urgent Care Professionals, PC CurrentSince Jul 25, 2022 Accepting new patients
Boston University Family Medicine, Inc. PastSince Jul 23, 2023 Accepting new patients

Locations

154 Great Rd
Bedford, MA 01730
Phone (781) 430-8161

960 Massachusetts Ave
Ste 2
Boston, MA 02118

1030 Main St
Waltham, MA 02451
Phone (781) 894-6900

Interoperability endpoints

  • Direct secure messaging: mkirya237160@direct.bmc.masshiway.net

Organizations & group practices 5

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": "1655337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1144950593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY STREET, SUITE 4B",
            "address_2": "SHAPIRO BLDG",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-638-5633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Powdermill Rd",
            "address_purpose": "LOCATION",
            "city": "Acton",
            "state": "MA",
            "postal_code": "017205932",
            "country_code": "US",
            "telephone_number": "978-234-6497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRYA",
        "first_name": "MARY",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-16",
        "last_updated": "2024-03-28",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA8777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.