Active NPI
Rebecca McClelland, PA-C, ATC
- Physician Assistant
- Boston, MA
National Provider Identifier
1457519597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1145141
- Practice address
- 55 Fruit St
Boston, MA 02114-2621 - Phone
- (617) 448-5619
- NPI assigned
- May 27, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 25MT00137000 | NJ | |
| Physician Assistant | 363A00000X | PA.0007017 | CO | |
| Physician Assistant | 363A00000X | 1145141 | MA | Primary |
Addresses
Primary practice location
55 Fruit St
Boston, MA 02114-2621
Mailing address
2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-2412
Other practice location 1
915 Commonwealth Ave
Boston University - Athletic Training Services
Boston, MA 02215-1394
Phone (617) 353-1595
Other practice location 2
1400 E Boulder St Ste 500
Colorado Springs, CO 80909-5533
Phone (719) 364-6487
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2006
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MT00137000 | NJ | MD | Athletic Trainer |
| PA.0007017 | CO | MD | Physician Assistant |
| 1145141 | MA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| General Hospital Corp | Current | Accepting new patients | |
| Massachusetts General Physicians Organization Inc | Current | Accepting new patients |
Locations
55 Fruit St
Boston, MA 02114
55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967
Interoperability endpoints
- mcclelland.rebecca.mgh@direct.partners.masshiway.net
Organizations & group practices 3
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.
-
- Dermatology Physician
- Boston, MA
- NPI 1801874573
-
- General Acute Care Hospital
- Boston, MA
- NPI 1023049236
-
- General Acute Care Hospital
- Boston, MA
- NPI 1508390014
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Boston, MA
- NPI 1790717650
-
- General Acute Care Hospital
- Salem, MA
- NPI 1730121633
-
- General Acute Care Hospital
- Boston, MA
- NPI 1023049236
-
- General Acute Care Hospital
- Dover, NH
- NPI 1033118104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696896000000",
"number": "1457519597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805389071",
"telephone_number": "970-624-2412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142621",
"telephone_number": "617-448-5619"
}
],
"practiceLocations": [
{
"address_1": "915 Commonwealth Ave",
"address_2": "Boston University - Athletic Training Services",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "022151394",
"country_code": "US",
"telephone_number": "617-353-1595",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1400 E Boulder St Ste 500",
"address_purpose": "LOCATION",
"city": "Colorado Springs",
"state": "CO",
"postal_code": "809095533",
"country_code": "US",
"telephone_number": "719-364-6487",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCCLELLAND",
"first_name": "REBECCA",
"name_prefix": "Ms.",
"credential": "PA-C, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-27",
"last_updated": "2023-10-10",
"certification_date": "2023-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NJ",
"license": "25MT00137000",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "PA.0007017",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "1145141",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.