Alexis Boyatsis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0936 Issued in NH

Practice address

1 Parkland Dr
Derry, NH 03038-2746

Phone

(603) 432-1500

NPI assigned

Apr 14, 2013

Last updated

Apr 14, 2013By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1365897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365897600000",
    "number": "1376986935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PARKLAND DR",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030382746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARKLAND DR",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030382746",
            "telephone_number": "603-432-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYATSIS",
        "first_name": "ALEXIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-14",
        "last_updated": "2013-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "0936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brian Fradette
• Broadway Chiropractic Office, PLLC

• Physician Assistant in Derry, NH
• Providers in Derry, NH by specialty
• Physician Assistant in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.