Active NPI
Edward Justin Breiby, P.A.
- Physician Assistant
- Boston, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA1531
- Practice address
- 75 Francis St
Boston, MA 02115-6110 - Phone
- (617) 732-7876
- NPI assigned
- Sep 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA1531 | MA | Primary |
| Surgical Physician Assistant | 363AS0400X | 1531 | MA |
Addresses
Primary practice location
75 Francis St
Boston, MA 02115-6110
Mailing address
75 Francis Street
Boston, MA 02115
Phone (781) 652-8806
Other practice location 1
41 Mall Rd
Burlington, MA 01805-6110
Phone (781) 744-8085
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lahey Clinic Inc
Practice addresses (Care Compare)
29 Mall Rd
Burlington, MA 01805-0001
41 Mall Rd
Burlington, MA 01805-0001
Hospital & facility affiliations
- Lahey Hospital & Medical Center, Burlington
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1531 | MA | MD | School Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lahey Clinic, Inc. | Current | Accepting new patients | |
| Lahey Clinic, Inc | Current | Accepting new patients | |
| Brigham and Women'S Hospital | Current | Accepting new patients | |
| Brigham and Womens Physicians Organization Inc | Past | Accepting new patients |
Locations
75 Francis St
#219
Boston, MA 02115
Phone (617) 732-7678
75 Francis St
Boston, MA 02115
41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400
Interoperability endpoints
- breiby.edward.bwh@direct.partners.masshiway.net
- ebreiby29682@tuftsmedicine.direct-ci.com
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.
-
- Internal Medicine Physician
- Peabody, MA
- NPI 1063447316
-
- Internal Medicine Physician
- Burlington, MA
- NPI 1538194980
-
- Internal Medicine Physician
- Boston, MA
- NPI 1033535497
-
- General Acute Care Hospital
- Boston, MA
- NPI 1093885816
-
- Diagnostic Radiology Physician
- Boston, MA
- NPI 1265464598
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Burlington, MA
- NPI 1558392563
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643068800000",
"number": "1154421899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 FRANCIS STREET",
"city": "BOSTON",
"state": "MA",
"postal_code": "02115",
"telephone_number": "781-652-8806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 FRANCIS ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021156110",
"telephone_number": "617-732-7876"
}
],
"practiceLocations": [
{
"address_1": "41 Mall Rd",
"address_purpose": "LOCATION",
"city": "Burlington",
"state": "MA",
"postal_code": "018056110",
"country_code": "US",
"telephone_number": "781-744-8085",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BREIBY",
"first_name": "EDWARD",
"middle_name": "JUSTIN",
"name_prefix": "Mr.",
"credential": "P.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-23",
"last_updated": "2022-01-25",
"certification_date": "2022-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "PA1531",
"primary": true
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "MA",
"license": "1531",
"primary": false
}
],
"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 Jan 25, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.