Individual provider Active NPI

Justyna Anna Wos, PA

  • Medical Physician Assistant
  • Springfield, MA
National Provider Identifier
1215582796
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA7143 Issued in MA
Practice address
759 Chestnut St
Springfield, MA 01107-1619
Phone
(413) 794-3233
Fax
(413) 794-9060
NPI assigned
Aug 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA7143 MA Primary

Addresses

Primary practice location

759 Chestnut St
Springfield, MA 01107-1619

Mailing address

280 Chestnut St FL 2
Springfield, MA 01199-1001
Phone (413) 794-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20220203002556 CT Practitioner - Physician Assistant 4880923598 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connecticut Imaging Partners LLCGroup PAC ID 4183649098, 105 clinicians
Jefferson Radiology PCGroup PAC ID 8729982525, 121 clinicians

Practice addresses (Care Compare)

1260 Silas Deane Hwy
Suite 104
Wethersfield, CT 06109-4363
Phone (860) 289-3375

1260 Silas Deane Hwy 100
Wethersfield, CT 06109-4363
Phone 860289337587099

130 Division St
Derby, CT 06418-1326
Phone (203) 735-7421

399 Farmington Ave
Farmington, CT 06032-1936
Phone (860) 289-3375

704 Hebron Ave
Suite 100
Glastonbury, CT 06033-5020
Phone (860) 289-3375

71 Haynes St
Manchester, CT 06040-4131
Phone (860) 289-3375

85 Seymour St
Suite 200
Hartford, CT 06106-5509
Phone (860) 289-3375

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5493CTMDPharmacist

Interoperability endpoints

  • Direct secure messaging: justyna.wos@xdr.hhchealthdirect.org

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1564704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1215582796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST FL 2",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "759 CHESTNUT ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071619",
            "telephone_number": "413-794-3233",
            "fax_number": "413-794-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOS",
        "first_name": "JUSTYNA",
        "middle_name": "ANNA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-02",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA7143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.