Individual provider Active NPI

Maria Elise Gargano, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1164890653
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
450 Brookline Ave
D2129
Boston, MA 02215-5418
Phone
(617) 632-5055
NPI assigned
Sep 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

450 Brookline Ave
D2129
Boston, MA 02215-5418

Mailing address

450 Brookline Ave
D2129
Boston, MA 02215-5418
Phone (617) 632-5055

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
I20161025000964 MA Practitioner - Physician Assistant 4981982006 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dana-Farber Cancer Institute, Inc. CurrentSince Sep 3, 2016 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Sep 3, 2016 Accepting new patients

Locations

450 Brookline Ave
#D2129
Boston, MA 02215
Phone (617) 632-5055

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

Interoperability endpoints

  • Direct secure messaging: gargano.maria.dfci@direct.partners.masshiway.net

Organizations & group practices 2

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": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1164890653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 BROOKLINE AVE",
            "address_2": "D2129",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155418",
            "telephone_number": "617-632-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BROOKLINE AVE",
            "address_2": "D2129",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155418",
            "telephone_number": "617-632-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARGANO",
        "first_name": "MARIA",
        "middle_name": "ELISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-14",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.