Justin Puckett

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

103 Garland St
Everett, MA 02149-5066

Phone

(617) 381-7133

NPI assigned

May 15, 2018

Sex

Male

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 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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cambridge Public Health CommissionGroup PAC ID 8921910894, 654 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cambridge Health Alliance Hospital, Cambridge, MA, CCN 220011
• Mount Auburn Hospital Hospital, Cambridge, MA, CCN 220002

Merit-based Incentive Payment System (MIPS)

Final score

91.27 of 100Reported as group

Quality

77.51

Promoting interoperability

100

Improvement activities

40

Cost

76.72

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpuckett86660@direct.challiance.masshiway.net

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.

• Cambridge Public Health Commission

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1932313228
  Medicare reassignment Care Compare group NPD
• Cambridge Public Health Commission

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1487603585
  NPD

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

• Cambridge Public Health Commission

  • Clinic/Center
  • Cambridge, MA
  • NPI 1306908405

  Hospital

  Care Compare affiliation
• Cambridge Public Health Commission

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1487603585
  Care Compare affiliation
• Mount Auburn Hospital

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1689670259
  Care Compare affiliation

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1417447475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3163 VALLEY LN",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853509",
            "telephone_number": "269-930-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 GARLAND ST",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021495066",
            "telephone_number": "617-381-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-15",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primecare Chiropractic of Everett
• Pro Brite Dental
• Pulmonary Associates of Greater Boston
• Anna Y Pustilnikova, RPH, PHARMD
• Shuyu Qiu
• Tofigh Raayai, DMD MSCD
• Ann Marie Ragucci, M.ED

• Physician Assistant in Everett, MA
• Providers in Everett, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.