Individual provider Active NPI

Emily Wacks, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1508291170
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA4811 Issued in MA
Practice address
185 Pilgrim Rd
Cardiology Baker 4
Boston, MA 02215
Phone
(414) 690-3515
NPI assigned
Sep 13, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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 PA4811 MA Primary

Addresses

Primary practice location

185 Pilgrim Rd
Cardiology Baker 4
Boston, MA 02215

Mailing address

1284 Beacon St Apt 215
Brookline, MA 02446-3733
Phone (414) 690-3515

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
I20181011000186 MA Practitioner - Physician Assistant 8729385273 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Deaconess Rd
Boston, MA 02215-5321
Phone (781) 983-9088

200 Boylston St
Chestnut Hill, MA 02467-2012
Phone (781) 983-9088

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 754-8612

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr, Inc CurrentSince Aug 19, 2018 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Oct 3, 2025 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Aug 19, 2018 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Oct 3, 2025 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Aug 19, 2018 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients

Locations

185 Pilgrim Rd
Boston, MA 02215
Phone (617) 632-8252

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

330 Brookline Ave
#9
Boston, MA 02215
Phone (617) 667-2100

185 Pilgrim Rd
#4
Boston, MA 02215
Phone (617) 632-7828

Interoperability endpoints

  • Direct secure messaging: ewacks253020@direct.bilh.masshiway.net

Organizations & group practices 6

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 1

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": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1508291170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1284 BEACON ST APT 215",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463733",
            "telephone_number": "414-690-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 PILGRIM RD",
            "address_2": "CARDIOLOGY BAKER 4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "414-690-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACKS",
        "first_name": "EMILY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-13",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.