Alexis Boyatsis, PA-C
Individual provider Active NPI Physician Assistant · Derry, NH
NPI 1376986935 · NPPES record last updated Apr 14, 2013
Key facts
- NPI
- 1376986935
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0936 (NH)
- Practice address
- 1 Parkland Dr
Derry, NH 03038-2746 - Phone
- (603) 432-1500
- NPI assigned
- Apr 14, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130904000481 | NH | Practitioner - Physician Assistant | 8224271606 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0936 | NH | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0936 | NH | Yes |
Addresses
Primary practice location
1 Parkland Dr
Derry, NH 03038-2746
Mailing address
1 Parkland Dr
Derry, NH 03038-2746
Other providers in Derry, NH
- Debra Boniface
- Phillip A. Bordonaro
- Heather Lynn Bortz
- Taylor Elanna Bosco
- Jamie David Boudreau
- Shannon Melissa Brancieri
- Brenda D Berkal DMD PC
- Brian D Tedesco, DPM & George a Abboud DPM PC
- Brian Fradette
- Broadway Chiropractic Office, PLLC
All providers in Derry, NH · Physician Assistant in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.