Individual provider Active NPI

Simone C Tomaino, PA-C

  • Medical Physician Assistant
  • Brockton, MA
National Provider Identifier
1528554581
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1139733 Issued in MA
Practice address
235 N Pearl St
Brockton, MA 02301-1794
Phone
(508) 427-3000
NPI assigned
Jul 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1139733 MA Primary

Addresses

Primary practice location

235 N Pearl St
Brockton, MA 02301-1794

Mailing address

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

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
I20180918000895 MA Practitioner - Physician Assistant 0648521427 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Operations PCGroup PAC ID 6406141217, 39 clinicians

Practice addresses (Care Compare)

450 Paradise Rd
Swampscott, MA 01907-1300
Phone (781) 691-9366

50 Dodge St
Suite 104
Beverly, MA 01915-1711

50 Dodge St
Suite 104
Beverly, MA 01915-1765
Phone (978) 922-2171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1139733MAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Patriot Urgent Care Professionals PC CurrentSince Aug 6, 2018 Accepting new patients
Patriot Urgent Care Professionals PC CurrentSince Aug 6, 2018 Accepting new patients
Urgent Care Operations PC CurrentSince Apr 23, 2023 Accepting new patients

Locations

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

50 Dodge St
Ste 104
Beverly, MA 01915
Phone (978) 922-2171

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

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, 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": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1528554581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 GREAT RD",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017302725",
            "telephone_number": "781-430-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 N PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011794",
            "telephone_number": "508-427-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMAINO",
        "first_name": "SIMONE",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "1139733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.