Individual provider Active NPI

Judith P Phillips, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1295258580
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA6173 Issued in MA
Practice address
732 Harrison Ave, FL 3 West
Preston BLDG
Boston, MA 02118
Phone
(617) 638-7350
Fax
(617) 638-7228
NPI assigned
Jul 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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 PA6173 MA Primary

Addresses

Primary practice location

732 Harrison Ave, FL 3 West
Preston BLDG
Boston, MA 02118

Mailing address

960 Massachusetts Avenue
FL 2
Boston, MA 02118-2690

Other practice location 1

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2045

Other identifiers 2

IdentifierTypeStateIssuer
3139069MedicaidNH
110131668AMedicaidMA

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
I20180324000098 MA Practitioner - Physician Assistant 5799047122 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA6173MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Boston University General Surgical Associates, Inc.-QMC CurrentSince Dec 19, 2022 Accepting new patients
Universal Hands Care Services LLC CurrentSince Aug 1, 2020 Accepting new patients
Steward Medical Group, Inc CurrentSince Apr 1, 2018 Accepting new patients
Steward Medical Group, Inc CurrentSince Apr 1, 2018 Accepting new patients

Locations

732 Harrison Ave
Fl 5
Boston, MA 02118
Phone (617) 414-6840

732 Harrison Ave
Fl 3
Boston, MA 02118
Phone (617) 638-5350

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

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

Interoperability endpoints

  • Direct secure messaging: jphillips178207@direct.bmc.masshiway.net

Organizations & group practices 6

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": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1295258580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVENUE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 HARRISON AVE, FL 3 WEST",
            "address_2": "PRESTON BLDG",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-638-7350",
            "fax_number": "617-638-7228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "736 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "02135",
            "country_code": "US",
            "telephone_number": "617-789-2045",
            "fax_number": "617-779-6760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JUDITH",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA6173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3139069",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110131668A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.