Individual provider Active NPI

Dakota K Blauvelt, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1366946808
Registry record updated Mar 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA6501 Issued in MA
Practice address
450 Brookline Ave
Boston, MA 02215-5450
Phone
(617) 632-3000
NPI assigned
Mar 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2018

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 PA6501 MA Primary

Addresses

Primary practice location

450 Brookline Ave
Boston, MA 02215-5450

Mailing address

8 Meade Rd
North Reading, MA 01864-3307
Phone (201) 669-7573

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
I20180516002097 MA Practitioner - Physician Assistant 2466716642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Tufts University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dana-Farber Cancer Institute, Inc.Group PAC ID 9133038904, 671 clinicians

Practice addresses (Care Compare)

450 Brookline Ave
Boston, MA 02215-5418
Phone (617) 632-3000

Hospital & facility affiliations

  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Dana-Farber Cancer Institute Hospital, Boston, MA, CCN 220162

Merit-based Incentive Payment System (MIPS)

Final score
84.06 of 100Reported as group
Quality
65.04
Promoting interoperability
100
Improvement activities
40
Cost
69.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA6501MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dana-Farber Cancer Institute, Inc. CurrentSince Apr 25, 2018 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Apr 25, 2018 Accepting new patients

Locations

450 Brookline Ave
#204
Boston, MA 02215
Phone (617) 632-3252

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

Interoperability endpoints

  • Direct secure messaging: blauvelt.dakota.dfci@direct.partners.masshiway.net

Organizations & group practices 2

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 2

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": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1366946808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MEADE RD",
            "city": "NORTH READING",
            "state": "MA",
            "postal_code": "018643307",
            "telephone_number": "201-669-7573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155450",
            "telephone_number": "617-632-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAUVELT",
        "first_name": "DAKOTA",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA6501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.