Elise Keni Wardell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA101751 Issued in MA

Practice address

840 Harrison Ave
Menino BLDG.
Boston, MA 02118

Phone

(617) 638-8609

NPI assigned

May 19, 2025

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

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Boston University General Surgical Associates, Inc.Group PAC ID 9830183763, 86 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ewardell267676@direct.bmc.masshiway.net

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.

• Boston University General Surgical Associates, Inc.

  • Surgery Physician
  • Boston, MA
  • NPI 1104865567
  Medicare reassignment Care Compare group
• Boston Medical Center Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1346218294
  NPD
• Boston University General Surgical Associates, Inc.-QMC

  • Podiatrist
  • Quincy, MA
  • NPI 1396041356
  NPD

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

{
    "created_epoch": "1747612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1376335216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVENUE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 HARRISON AVE",
            "address_2": "MENINO BLDG.",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-638-8609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Albany Street, Suite 3B",
            "address_2": "Shapiro Bldg.",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02118",
            "country_code": "US",
            "telephone_number": "617-414-4861",
            "fax_number": "617-414-3617",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1678 Asylum Ave",
            "address_purpose": "LOCATION",
            "city": "West Hartford",
            "state": "CT",
            "postal_code": "061172764",
            "country_code": "US",
            "telephone_number": "860-232-4571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARDELL",
        "first_name": "ELISE",
        "middle_name": "KENI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-19",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA101751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110222918A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert J Ward, M.D.
• Siobhan E Ward
• Taylor Ward, PHARMD
• Valerie L Ward, MD
• Veronica A. Ward, DNP, ANP-BC
• Hanna Wardell, M.D.
• Andrea Hutcheson Warden, NP
• Kimberly Suvak Warden, MSN, CNP, NP-C
• Marissa Joan Wardwell, CNP
• Janice Ware, PH.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; 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.