Individual provider Active NPI

Zachary R Witter, PA

  • Physician Assistant
  • Foxborough, MA
National Provider Identifier
1174170112
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA8965 Issued in MA
Practice address
22 Patriot PL
Foxborough, MA 02035-1375
Phone
(508) 718-4050
Fax
(508) 718-4051
NPI assigned
Aug 23, 2019
Last updated
Jan 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 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 PA8965 MA Primary

Addresses

Primary practice location

22 Patriot PL
Foxborough, MA 02035-1375

Mailing address

75 Francis St
Boston, MA 02115-6106
Phone (617) 732-5500

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
I20221108001837 MA Practitioner - Physician Assistant 0941612857 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Northwestern University Feinberg Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

20 Patriot PL
Foxborough, MA 02035-1375
Phone (508) 718-4000

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA8965MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc CurrentSince Oct 1, 2022 Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

254 2nd Ave
Ste 100
Needham Heights, MA 02494
Phone (781) 416-8413

Interoperability endpoints

  • Direct secure messaging: witter.zachary.bwh@direct.partners.masshiway.net
  • Direct secure messaging: zwitter411435@direct.dartmouth-hitchcock.org

Organizations & group practices 3

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 4

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": "1566518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1174170112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156106",
            "telephone_number": "617-732-5500",
            "fax_number": "508-718-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 PATRIOT PL",
            "city": "FOXBOROUGH",
            "state": "MA",
            "postal_code": "020351375",
            "telephone_number": "508-718-4050",
            "fax_number": "508-718-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTER",
        "first_name": "ZACHARY",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-23",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA8965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Foxborough, MA

Sources for this page

Verify at the official NPI Registry.