Individual provider Active NPI

Vasso Anest Kumarelas, PA-C

  • Medical Physician Assistant
  • Brookline, MA
National Provider Identifier
1477910537
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA6390 Issued in MA
Practice address
1285 Beacon St
Brookline, MA 02446-5237
Phone
(617) 751-6205
Fax
(617) 487-8663
NPI assigned
Jan 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA1688 NV
Medical Physician Assistant 363AM0700X MA6390 MA Primary

Addresses

Primary practice location

1285 Beacon St
Brookline, MA 02446-5237

Mailing address

1720 W Horizon Ridge Pkwy Ste 140
Henderson, NV 89012-4896
Phone (702) 566-5445

Other practice location 1

1720 W Horizon Ridge Pkwy Ste 140
Henderson, NV 89012-4896
Phone (702) 566-5445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240130001480 CA Practitioner - Physician Assistant 3173896321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Camino Health Medical Network LLCGroup PAC ID 6103115183, 202 clinicians

Practice addresses (Care Compare)

1150 W El Camino Real
Mountain View, CA 94040-2518
Phone (650) 988-7667

4150 N 1St St
San Jose, CA 95134-1513
Phone (408) 871-3400

625 Lincoln Ave
San Jose, CA 95126-3785
Phone (408) 871-3400

815 Pollard Rd
Los Gatos, CA 95032-1438
Phone (408) 866-4070

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA6390MAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 Past Accepting new patients
El Camino Health Medical Group Past Accepting new patients
Carbon Health Primary Care of California PC PastSince Jul 20, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: vkumarelas183345@icare.elcaminohospital.org

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 3

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": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1477910537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 W HORIZON RIDGE PKWY STE 140",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890124896",
            "telephone_number": "702-566-5445",
            "fax_number": "702-566-5035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 BEACON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465237",
            "telephone_number": "617-751-6205",
            "fax_number": "617-487-8663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 W Horizon Ridge Pkwy Ste 140",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890124896",
            "country_code": "US",
            "telephone_number": "702-566-5445",
            "fax_number": "702-566-5035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUMARELAS",
        "first_name": "VASSO",
        "middle_name": "ANEST",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-20",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA1688",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "MA6390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.