Active NPI
Anastasia Maniatis
- Student in an Organized Health Care Education/Training Program
- Watertown, MA
National Provider Identifier
1497616783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- PI1000053
- Practice address
- 309 Main St
Watertown, MA 02472-2359 - Phone
- (617) 553-2501
- NPI assigned
- Nov 18, 2025
- Last updated
- Nov 18, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | PI1000053 | MA | Primary |
Addresses
Primary practice location
309 Main St
Watertown, MA 02472-2359
Mailing address
309 Main St
Watertown, MA 02472-2359
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PI1000053 | MA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sun Health Systems | Current | Accepting new patients | |
| Sun Health Systems | Current | Accepting new patients |
Locations
309 Main St
Watertown, MA 02472
Phone (617) 429-0942
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1763424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763424000000",
"number": "1497616783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 MAIN ST",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024722359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 MAIN ST",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024722359",
"telephone_number": "617-553-2501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANIATIS",
"first_name": "ANASTASIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-11-18",
"last_updated": "2025-11-18",
"certification_date": "2025-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MA",
"license": "PI1000053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.