Individual provider Active NPI

Raksa Chet Son, PA-C

  • Physician Assistant
  • Lowell, MA
National Provider Identifier
1306471628
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7478 Issued in MA
Practice address
165 Thorndike St FL 4
Lowell, MA 01852-3485
Phone
(978) 955-9500
NPI assigned
Mar 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 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 7478 MA Primary

Addresses

Primary practice location

165 Thorndike St FL 4
Lowell, MA 01852-3485

Mailing address

165 Thorndike St FL 4
Lowell, MA 01852-3485

Other practice location 1

19 Dodge St Ste B
Beverly, MA 01915-1705
Phone (781) 328-6542

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
I20220422002042 MA Practitioner - Physician Assistant 4082001979 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Tufts University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mill City Medical Group LTDGroup PAC ID 3577507797, 19 clinicians

Practice addresses (Care Compare)

165 Thorndike St
FL 4
Lowell, MA 01852-3485
Phone (978) 955-9500

595 Pawtucket Blvd
Suite 2
Lowell, MA 01854-2042
Phone (978) 955-9500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7478MAMDHealth Service Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Clinic Primary Care PLLC Current Accepting new patients
Patriot Urgent Care Professionals PC CurrentSince May 22, 2022 Accepting new patients
CVS Clinic Primary Care PLLC CurrentSince Jul 21, 2025 Accepting new patients
CVS Clinic PLLC CurrentSince Jul 21, 2025 Accepting new patients
NPI 1518715812 CurrentSince Jul 21, 2025 Accepting new patients
Patriot Urgent Care Professionals PC CurrentSince May 22, 2022 Accepting new patients

Locations

154 Great Rd
Bedford, MA 01730
Phone (781) 430-8161

19 Dodge St
#B
Beverly, MA 01915
Phone (781) 328-6542

413 Paradise Rd
#B
Swampscott, MA 01907
Phone (978) 922-2003

1030 Main St
Waltham, MA 02451
Phone (781) 894-6900

Organizations & group practices 9

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 1

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": "1583452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1306471628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 THORNDIKE ST FL 4",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018523485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 THORNDIKE ST FL 4",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018523485",
            "telephone_number": "978-955-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Dodge St Ste B",
            "address_purpose": "LOCATION",
            "city": "Beverly",
            "state": "MA",
            "postal_code": "019151705",
            "country_code": "US",
            "telephone_number": "781-328-6542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SON",
        "first_name": "RAKSA",
        "middle_name": "CHET",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-06",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "7478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.