Individual provider Active NPI

Jonathan Wayman Pisarski, PA-C

  • Physician Assistant
  • Cambridge, MA
National Provider Identifier
1588964068
Registry record updated Nov 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA4233 Issued in MA
Practice address
330 Mount Auburn St
Department of Medicine
Cambridge, MA 02138-5502
Phone
(617) 492-3500
NPI assigned
Oct 29, 2010
Last updated
Nov 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2013

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 PA4233 MA Primary

Addresses

Primary practice location

330 Mount Auburn St
Department of Medicine
Cambridge, MA 02138-5502

Mailing address

270 Overlook Rd
Glastonbury, CT 06033-3618
Phone (860) 805-6427

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
I20120124000904 MA Practitioner - Physician Assistant 6204003791 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4233MAMDOccupational Therapy Assistant
PA4233MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mt Auburn Professional Services CurrentSince Jan 10, 2012 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Jan 9, 2019 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

330 Mount Auburn St
Cambridge, MA 02138
Phone (617) 499-5054

57 Bedford St
Ste 130
Lexington, MA 02420
Phone (781) 484-7500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/86/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jpisarski252847@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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384732800000",
    "number": "1588964068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 OVERLOOK RD",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060333618",
            "telephone_number": "860-805-6427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MOUNT AUBURN ST",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385502",
            "telephone_number": "617-492-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISARSKI",
        "first_name": "JONATHAN",
        "middle_name": "WAYMAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-29",
        "last_updated": "2013-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.