Individual provider Active NPI

Lampros A Minos, PA-C

  • Surgical Physician Assistant
  • Waltham, MA
National Provider Identifier
1396892097
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
579 Issued in MA
Practice address
840 Winter St
Waltham, MA 02451-1433
Phone
(617) 738-8642
Fax
(617) 202-4172
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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 579 MA Primary

Addresses

Primary practice location

840 Winter St
Waltham, MA 02451-1433

Mailing address

20 Guest St Ste 225
Brighton, MA 02135-2065
Phone (617) 738-8642

Other practice location 1

300 Mount Auburn St
Suite 505
Cambridge, MA 02138-5600
Phone (617) 491-6766

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
I20080530000032 MA Practitioner - Physician Assistant 4183794365 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston Orthopaedic and Spine LLCGroup PAC ID 3476983909, 20 clinicians

Practice addresses (Care Compare)

20 Guest St
Suite 225
Brighton, MA 02135-2065
Phone (617) 738-8642

71 Border Rd
Suite 200
Waltham, MA 02451-1044
Phone (617) 738-8642

840 Winter St
Waltham, MA 02451-1433
Phone (781) 487-9444

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
579MAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Mar 1, 2020 Accepting new patients
Pro Sports Orthopedics, Inc Current Accepting new patients
Steward Medical Group, Inc CurrentSince Mar 1, 2020 Accepting new patients
Massachusetts Institute of Technology Past Accepting new patients

Locations

20 Guest St
Ste 225
Brighton, MA 02135
Phone (617) 586-1900

736 Cambridge St
Fl 7
Brighton, MA 02135
Phone (617) 562-7026

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

300 Mount Auburn St
Ste 505
Cambridge, MA 02138
Phone (617) 491-6766

840 Winter St
Waltham, MA 02451
Phone (781) 487-9944

Interoperability endpoints

  • Direct secure messaging: lampros.minos.1@14781.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1396892097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GUEST ST STE 225",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021352065",
            "telephone_number": "617-738-8642",
            "fax_number": "617-202-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 WINTER ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511433",
            "telephone_number": "617-738-8642",
            "fax_number": "617-202-4172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Mount Auburn St",
            "address_2": "Suite 505",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MA",
            "postal_code": "021385600",
            "country_code": "US",
            "telephone_number": "617-491-6766",
            "fax_number": "617-491-2552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINOS",
        "first_name": "LAMPROS",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.