NPIMap

Individual provider Active NPI

David Decoteau, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1285189845
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA5893 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2696
Phone
(617) 724-4100
NPI assigned
Aug 23, 2016
Last updated
Jul 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA5893 MA Primary
Physician Assistant 363A00000X 23.003656 CT
Medical Physician Assistant 363AM0700X 003656 CT

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2696

Mailing address

399 Revolution Dr Ste 458
Somerville, MA 02145-1488
Phone (860) 972-0000

Other practice location 1

80 Seymour Street
Hartford Hospital Emergency Medicine
Hartford, CT 06102-5037
Phone (860) 972-0000

Other practice location 2

56 Franklin St
Waterbury, CT 06706-1253
Phone (203) 709-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161108002051 MA Practitioner - Physician Assistant 4587942057 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston Emergency Physician Foundation IncGroup PAC ID 4981596095, 74 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 414-5481

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3656CTMDProfessional Counselor
003656CTMDClinical Social Worker
23.003656CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients

Locations

1 Boston Medical Ctr Pl
Roxbury, MA 02118
Phone (617) 414-5245

Interoperability endpoints

  • Direct secure messaging: david.decoteau@xdr.hhchealthdirect.org
  • Direct secure messaging: ddecoteau119196@direct.bmc.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 8

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": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1285189845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 REVOLUTION DR STE 458",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021451488",
            "telephone_number": "860-972-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-724-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Seymour Street",
            "address_2": "Hartford Hospital Emergency Medicine",
            "address_purpose": "LOCATION",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025037",
            "country_code": "US",
            "telephone_number": "860-972-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "56 Franklin St",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067061253",
            "country_code": "US",
            "telephone_number": "203-709-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECOTEAU",
        "first_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-23",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA5893",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "23.003656",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "003656",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.