Theresa Fukuda, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

43 Bowdoin St Apt 2F
Boston, MA 02114-4238

Phone

(802) 999-3882

NPI assigned

Apr 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Tufts University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Robert J Obrien Jr MD and Assoc PCGroup PAC ID 1557250586, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Winchester Hospital Hospital, Winchester, MA, CCN 220105

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Robert J Obrien Jr MD & Assoc PC

  • Dermatology Physician
  • Winchester, MA
  • NPI 1588646715
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Winchester Hospital

  • General Acute Care Hospital
  • Winchester, MA
  • NPI 1790740777
  Care Compare affiliation

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1366006330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 BOWDOIN ST APT 2F",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021144238",
            "telephone_number": "802-999-3882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 BOWDOIN ST APT 2F",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021144238",
            "telephone_number": "802-999-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKUDA",
        "first_name": "THERESA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092289",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Fuini, LICSW
• Alan Minora Fujii, MD
• Brandon Fujii
• Asahi Fujita
• Shohei Fujita, MD, PHD
• Eugene Yoshio Fukudome, MD
• Mieko Fukui, MD
• Sarah Fulco, MD
• Alyne Fulgencio, RN
• Cristina Maria Fulgoni

• Medical Physician Assistant in Boston, MA
• Providers in Boston, MA by specialty
• Medical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; 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.

Verify at the official NPI Registry.