Individual provider Active NPI

Kristen Dawn Marcella, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1336172782
Registry record updated Nov 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1958 Issued in MA
Practice address
330 Brookline Ave
Boston, MA 02215-5400
Phone
(617) 667-2932
NPI assigned
Jul 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2015

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 1958 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Boston, MA 02215-5400

Mailing address

1493 Cambridge St
Cambridge, MA 02139-1047
Phone (617) 665-1000

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
I20051208000706 MA Practitioner - Physician Assistant 3678544905 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001441CTMDMarriage & Family Therapist
1958MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Current Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Oct 10, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Oct 10, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients

Locations

330 Brookline Ave
#407
Boston, MA 02215

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

Interoperability endpoints

  • Direct secure messaging: kmarcella254044@direct.bilh.masshiway.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447200000000",
    "number": "1336172782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1493 CAMBRIDGE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391047",
            "telephone_number": "617-665-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELLA",
        "first_name": "KRISTEN",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2015-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "1958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.