Individual provider Active NPI

Victoria Burdett, PA

  • Physician Assistant
  • Worcester, MA
National Provider Identifier
1215426986
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA6453 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(774) 443-7552
Fax
(774) 441-6086
NPI assigned
May 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 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 PA6453 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other practice location 1

119 Belmont St
Worcester, MA 01605-2903
Phone (774) 443-7552

Other practice location 2

55 Fogg Rd
South Weymouth, MA 02190-2455
Phone (781) 624-8000

Other identifiers 1

IdentifierTypeStateIssuer
110135913AMedicaidMA

Other names 1

  • Victoria Pearce Former name

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
I20180622000483 MA Practitioner - Physician Assistant 8123373792 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Medical Group, Inc CurrentSince Jun 16, 2023 Accepting new patients
Pratt Medical Group, Inc CurrentSince Jun 16, 2023 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Jun 1, 2021 Accepting new patients
Umass Memorial Medical Group Inc Physician Assistant CurrentSince Jun 1, 2021 Accepting new patients
Pratt Medical Group, Inc Past Accepting new patients

Locations

320 Pomfret St
Putnam, CT 06260
Phone (860) 963-6331

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

800 Washington St
#3
Boston, MA 02111
Phone (617) 636-1636

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1215426986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "774-443-7552",
            "fax_number": "774-441-6086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 Belmont St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052903",
            "country_code": "US",
            "telephone_number": "774-443-7552",
            "fax_number": "774-441-6086",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Fogg Rd",
            "address_purpose": "LOCATION",
            "city": "South Weymouth",
            "state": "MA",
            "postal_code": "021902455",
            "country_code": "US",
            "telephone_number": "781-624-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURDETT",
        "first_name": "VICTORIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA6453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110135913A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "PEARCE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.