Individual provider Active NPI

Marriann Dew, PA-C

  • Physician Assistant
  • Somerville, MA
National Provider Identifier
1164298568
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
69 Bonair St Apt 2
Somerville, MA 02145-3078
Phone
(315) 243-6920
NPI assigned
Nov 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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 Primary

Addresses

Primary practice location

69 Bonair St Apt 2
Somerville, MA 02145-3078

Mailing address

69 Bonair St Apt 2
Somerville, MA 02145-3078
Phone (315) 243-6920

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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1164298568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 BONAIR ST APT 2",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021453078",
            "telephone_number": "315-243-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 BONAIR ST APT 2",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021453078",
            "telephone_number": "315-243-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEW",
        "first_name": "MARRIANN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

Verify at the official NPI Registry.