Active NPI
Michael Llewellyn, PA-C
- Surgical Physician Assistant
- Boston, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- Practice address
- 55 Fruit St
Boston, MA 02114-2621 - Phone
- (617) 643-9253
- NPI assigned
- Jun 10, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | Primary |
Addresses
Primary practice location
55 Fruit St
Boston, MA 02114-2621
Mailing address
1275 York Ave
8TH Floor, C Building
New York, NY 10065-6007
Phone (516) 313-3270
Other practice location 1
1275 York Ave
8th Floor, C Building
New York, NY 10065-6007
Phone (516) 313-3270
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287
Hospital & facility affiliations
- Massachusetts General Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Massachusetts General Physicians Organization Inc | Current | Accepting new patients | |
| General Hospital Corp | Current | Accepting new patients |
Locations
55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967
55 Fruit St
Boston, MA 02114
Interoperability endpoints
- llewellyn.michael.mgh@direct.partners.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.
-
- Dermatology Physician
- Boston, MA
- NPI 1801874573
-
- General Acute Care Hospital
- Boston, MA
- NPI 1023049236
-
- Surgical Oncology Physician
- New York, NY
- NPI 1699766261
-
- General Acute Care Hospital
- Boston, MA
- NPI 1508390014
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Boston, MA
- NPI 1023049236
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673395200000",
"number": "1346688504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1275 YORK AVE",
"address_2": "8TH FLOOR, C BUILDING",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100656007",
"telephone_number": "516-313-3270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142621",
"telephone_number": "617-643-9253"
}
],
"practiceLocations": [
{
"address_1": "1275 York Ave",
"address_2": "8th Floor, C Building",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100656007",
"country_code": "US",
"telephone_number": "516-313-3270",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LLEWELLYN",
"first_name": "MICHAEL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-10",
"last_updated": "2023-01-11",
"certification_date": "2023-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.