Individual provider Active NPI

Ian Perla

  • Physician Assistant
  • Stow, MA
National Provider Identifier
1376423160
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA102059 Issued in MA
Practice address
17 October LN
Stow, MA 01775-1037
Phone
(978) 235-7349
NPI assigned
Sep 3, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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 PA102059 MA Primary

Addresses

Primary practice location

17 October LN
Stow, MA 01775-1037

Mailing address

17 October LN
Stow, MA 01775-1037

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
I20251117002859 MA Practitioner - Physician Assistant 3375034465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patriot Urgent Care Professionals PCGroup PAC ID 8820248784, 41 clinicians

Practice addresses (Care Compare)

154 Great Rd
Bedford, MA 01730-2725
Phone (781) 430-8161

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA102059MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Patriot Urgent Care Professionals, PC CurrentSince Nov 1, 2025 Accepting new patients
Patriot Urgent Care Professionals PC CurrentSince Nov 1, 2025 Accepting new patients
Patriot Urgent Care Professionals, PC Current Accepting new patients

Locations

154 Great Rd
Bedford, MA 01730
Phone (781) 430-8161

1030 Main St
Waltham, MA 02451
Phone (781) 894-6900

Organizations & group practices 3

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": "1756857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1376423160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 OCTOBER LN",
            "city": "STOW",
            "state": "MA",
            "postal_code": "017751037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 OCTOBER LN",
            "city": "STOW",
            "state": "MA",
            "postal_code": "017751037",
            "telephone_number": "978-235-7349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERLA",
        "first_name": "IAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA102059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stow, MA

Sources for this page

Verify at the official NPI Registry.