Individual provider Active NPI

Ian Hayes Nagus, PAC

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1205995834
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AP2160 Issued in MA
Practice address
44 Binney St
Dana Farber Cancer Institute
Boston, MA 02115
Phone
(617) 632-6464
Fax
(617) 278-6965
NPI assigned
Dec 8, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 AP2160 MA Primary

Addresses

Primary practice location

44 Binney St
Dana Farber Cancer Institute
Boston, MA 02115

Mailing address

148 Strathmore Rd
Apt 1
Brighton, MA 02135
Phone (617) 519-9451

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
I20070106000053 MA Practitioner - Physician Assistant 1759381221 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
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

81 Highland Ave
Salem, MA 01970-2714
Phone (978) 741-1200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP2160MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dana-Farber Cancer Institute, Inc. CurrentSince Aug 3, 2006 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Jan 11, 2016 Accepting new patients

Locations

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

55 Fruit St
Boston, MA 02114

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

Interoperability endpoints

  • Direct secure messaging: nagus.ian.dfci@direct.partners.masshiway.net

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 1

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205995834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 STRATHMORE RD",
            "address_2": "APT 1",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "02135",
            "telephone_number": "617-519-9451",
            "fax_number": "617-278-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 BINNEY ST",
            "address_2": "DANA FARBER CANCER INSTITUTE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115",
            "telephone_number": "617-632-6464",
            "fax_number": "617-278-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGUS",
        "first_name": "IAN",
        "middle_name": "HAYES",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "AP2160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.