Individual provider Active NPI

Samantha Jewers

  • Physician Assistant
  • Watertown, MA
National Provider Identifier
1457961765
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
20 California Park
Watertown, MA 02472-2517
Phone
(617) 458-1818
NPI assigned
Aug 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

20 California Park
Watertown, MA 02472-2517

Mailing address

20 California Park
Watertown, MA 02472-2517
Phone (617) 458-1818

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
I20201208001225 MA Practitioner - Physician Assistant 8729490297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1019 Trapelo Rd
Waltham, MA 02452-5002
Phone (774) 400-4084

1030 Main St
Waltham, MA 02451-7447
Phone (781) 894-6900

1210 Boylston St
Chestnut Hill, MA 02467-2109
Phone (774) 400-4084

154 Great Rd
Bedford, MA 01730-2725
Phone (781) 430-8161

16 Main St
Stoneham, MA 02180-3334
Phone (781) 279-4000

17 White St
Cambridge, MA 02140-1413
Phone (781) 430-9161

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Patriot Urgent Care Professionals PC CurrentSince Oct 1, 2020 Accepting new patients
Patriot Urgent Care Professionals PC CurrentSince Oct 1, 2020 Accepting new patients

Locations

154 Great Rd
Bedford, MA 01730
Phone (781) 430-8161

1030 Main St
Waltham, MA 02451
Phone (781) 894-6900

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.

NPI Registry JSON

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1457961765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CALIFORNIA PARK",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024722517",
            "telephone_number": "617-458-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CALIFORNIA PARK",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024722517",
            "telephone_number": "617-458-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEWERS",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, MA

Sources for this page

Verify at the official NPI Registry.