NPIMap

Individual provider Active NPI

Kerry Eaton

  • Physician Assistant
  • Wilmington, MA
National Provider Identifier
1164180659
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA8930 Issued in MA
Practice address
66 Concord St
Wilmington, MA 01887-2179
Phone
(978) 694-9610
NPI assigned
Dec 2, 2021
Last updated
Apr 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X PA8930 MA Primary

Addresses

Primary practice location

66 Concord St
Wilmington, MA 01887-2179

Mailing address

66 Concord St
Wilmington, MA 01887-2179
Phone (978) 694-9610

Other practice location 1

495 Western Ave
Brighton, MA 02135-1007
Phone (617) 783-0500 ext. 30500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221125000266 MA Practitioner - Physician Assistant 9032587985 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Tufts University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, 1,381 clinicians

Practice addresses (Care Compare)

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8771

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Primary Care, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Lahey Clinic, Inc CurrentSince Jul 1, 2024 Accepting new patients
Charles River Community Health, Inc CurrentSince Sep 7, 2022 Accepting new patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Sep 1, 2025 Accepting new patients
Charles River Community Health, Inc CurrentSince Sep 7, 2022 Accepting new patients

Locations

495 Western Ave
Brighton, MA 02135

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.laheyhealth.org/proxy-prd-fhir/api/FHIR/R4/
  • Direct secure messaging: keaton25228@direct.ctc.masshiway.net

Organizations & group practices 6

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 5

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": "1638403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1164180659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 CONCORD ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018872179",
            "telephone_number": "978-694-9610",
            "fax_number": "978-694-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 CONCORD ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018872179",
            "telephone_number": "978-694-9610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "495 Western Ave",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021351007",
            "country_code": "US",
            "telephone_number": "617-783-0500 x30500",
            "fax_number": "617-562-1398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EATON",
        "first_name": "KERRY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-02",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA8930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, MA

Sources for this page

Verify at the official NPI Registry.