Individual provider Active NPI

Julie Ann Mucciarone, PA-C

  • Surgical Physician Assistant
  • Boston, MA
National Provider Identifier
1205131604
Registry record updated Jan 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA4038 Issued in MA
Practice address
55 Fruit St
Yawkey 9E
Boston, MA 02114-2621
Phone
(617) 643-2402
NPI assigned
Jan 14, 2011
Last updated
Jan 14, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA4038 MA Primary

Addresses

Primary practice location

55 Fruit St
Yawkey 9E
Boston, MA 02114-2621

Mailing address

55 Fruit St
Yawkey 9E
Boston, MA 02114-2621
Phone (617) 643-2402

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
I20110331000813 MA Practitioner - Physician Assistant 2668655424 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

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
PA4038MAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc CurrentSince Dec 7, 2020 Accepting new patients
Harbor Medical Associates, Inc. CurrentSince Dec 7, 2020 Accepting new patients
General Hospital Corp Current Accepting new patients
Mass General Brigham Medical Group Suburban Massachusetts Inc CurrentSince Jan 1, 2026 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Jan 13, 2011 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
#9E
Boston, MA 02114
Phone (617) 724-4800

75 Francis St
Boston, MA 02115

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

541 Main St
Ste 314
Weymouth, MA 02190
Phone (781) 952-1200

Interoperability endpoints

  • Direct secure messaging: mucciarone.julie.mgh@direct.partners.masshiway.net

Organizations & group practices 7

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 2

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": "1294963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1205131604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "YAWKEY 9E",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-643-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "YAWKEY 9E",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-643-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCCIARONE",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-14",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA4038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.