Individual provider Active NPI

Vincent James Stella III, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1568981249
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA6354 Issued in MA
Practice address
125 Parker Hill Ave Ste 2
Boston, MA 02120-2865
Phone
(617) 754-5754
Fax
(617) 754-6490
NPI assigned
Sep 14, 2017
Last updated
Aug 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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 PA6354 MA Primary

Addresses

Primary practice location

125 Parker Hill Ave Ste 2
Boston, MA 02120-2865

Mailing address

40 Orchard Ave # 0
Weston, MA 02493-2219
Phone (203) 260-6628

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
I20171114000008 MA Practitioner - Physician Assistant 1951667633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New England Baptist Medical Associates, Inc.Group PAC ID 2365439783, 77 clinicians

Practice addresses (Care Compare)

125 Parker Hill Ave
Boston, MA 02120-2847
Phone (617) 754-5800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA6354MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Cod Orthopedics and Sports Medicine PC CurrentSince Oct 24, 2017 Accepting new patients
Cape Cod Orthopedics and Sports Medicine PC CurrentSince Oct 24, 2017 Accepting new patients
Neb Radiology PC PastSince Aug 27, 2023 Accepting new patients

Locations

130 North St
Hyannis, MA 02601
Phone (508) 568-3761

Interoperability endpoints

  • Direct secure messaging: vstella371455@direct.bilh.masshiway.net

Organizations & group practices 4

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.

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": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1568981249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 ORCHARD AVE # 0",
            "city": "WESTON",
            "state": "MA",
            "postal_code": "024932219",
            "telephone_number": "203-260-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PARKER HILL AVE STE 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021202865",
            "telephone_number": "617-754-5754",
            "fax_number": "617-754-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STELLA",
        "first_name": "VINCENT",
        "middle_name": "JAMES",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-14",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA6354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.