Individual provider Active NPI

Pamela V. Phillips, CRNA

  • Certified Registered Nurse Anesthetist
  • Boston, MA
National Provider Identifier
1255306882
Registry record updated May 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN2271635 Issued in MA
Practice address
800 Washington St
Boston, MA 02111
Phone
(617) 636-5000
NPI assigned
Feb 17, 2006
Last updated
May 31, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP2577392 FL
Certified Registered Nurse Anesthetist 367500000X RN2271635 MA Primary

Addresses

Primary practice location

800 Washington St
Boston, MA 02111

Mailing address

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

Other practice location 1

1613 Harrison Pkwy
#200
Sunrise, FL 33323-2853
Phone (954) 838-2371

Other practice location 2

1613 Harrison Pkwy
#200
Sunrise, FL 33323-2853
Phone (954) 838-2371

Other identifiers 1

IdentifierTypeStateIssuer
304220100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110623000210 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234123837 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lowell Anesthesia Associates PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 7, 2023 Accepting new patients
Pratt Anesthesiology Associates, Inc CurrentSince Dec 16, 2015 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Sep 1, 2013 Accepting new patients
South Florida Gastroenterology Associates PA PastSince Mar 3, 1997 Accepting new patients

Locations

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

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

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

59 Lowes Way
Lowell, MA 01851
Phone (617) 733-4166

585 Lebanon St
Melrose, MA 02176
Phone (781) 979-3026

800 Washington St
Norwood, MA 02062
Phone (781) 278-6264

1A Burton Hills Blvd
Nashville, TN 37215
Phone (615) 263-5579

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1255306882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02111",
            "telephone_number": "617-636-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1613 Harrison Pkwy",
            "address_2": "#200",
            "address_purpose": "LOCATION",
            "city": "Sunrise",
            "state": "FL",
            "postal_code": "333232853",
            "country_code": "US",
            "telephone_number": "954-838-2371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1613 Harrison Pkwy",
            "address_2": "#200",
            "address_purpose": "LOCATION",
            "city": "Sunrise",
            "state": "FL",
            "postal_code": "333232853",
            "country_code": "US",
            "telephone_number": "954-838-2371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "PAMELA",
        "middle_name": "V.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP2577392",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN2271635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304220100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.