Individual provider Active NPI

Andrea M Tortolano, PA

  • Surgical Physician Assistant
  • Woburn, MA
National Provider Identifier
1386834323
Registry record updated Nov 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2314 Issued in MA
Practice address
200 Unicorn Park Dr
Ste 201
Woburn, MA 01801-3342
Phone
(781) 782-1300
Fax
(781) 782-1350
NPI assigned
Jul 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 2314 MA Primary

Addresses

Primary practice location

200 Unicorn Park Dr
Ste 201
Woburn, MA 01801-3342

Mailing address

200 Unicorn Park Dr
Ste 201
Woburn, MA 01801-3342
Phone (781) 782-1300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080529000235 MA Practitioner - Physician Assistant 7012087307 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2314MAMDSurgical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: atortolano52858@tuftsmedicine.direct-ci.com

Organizations & group practices 1

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": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1386834323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 UNICORN PARK DR",
            "address_2": "STE 201",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018013342",
            "telephone_number": "781-782-1300",
            "fax_number": "781-782-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UNICORN PARK DR",
            "address_2": "STE 201",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018013342",
            "telephone_number": "781-782-1300",
            "fax_number": "781-782-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORTOLANO",
        "first_name": "ANDREA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "2314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

Verify at the official NPI Registry.