NPIMap

Individual provider Active NPI

Brandin Phillips, PA-C

  • Physician Assistant
  • Newton, MA
National Provider Identifier
1629473293
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA8709 Issued in MA
Practice address
2014 Washington St
Newton, MA 02462-1607
Phone
(617) 243-6040
NPI assigned
Oct 24, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 52101 CA
Physician Assistant 363A00000X 1340 NH
Physician Assistant 363A00000X PA8709 MA Primary

Addresses

Primary practice location

2014 Washington St
Newton, MA 02462-1607

Mailing address

7 Thorndike Ter Apt 2
Swampscott, MA 01907-2526
Phone (916) 284-0212

Other practice location 1

351 Winchester St
Keene, NH 03431-3930
Phone (603) 352-3406

Other practice location 2

1990 N California Blvd
Suite 400
Walnut Creek, CA 94596-3742
Phone (925) 482-8240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150209000824 CA Practitioner - Physician Assistant 8123343431 Reassigns benefits to 4 organizations
I20220510002554 MA Practitioner - Physician Assistant 8123343431 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5145CTMDSocial Worker
1340NHMDClinical Social Worker
52101CAMDMarriage & Family Therapist
PA8709MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Newton Wellesley Hospital Current Accepting new patients
Cep America - California CurrentSince Dec 1, 2015 Accepting new patients
North Sonoma County Health Care District Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1600 N Rose Ave
Oxnard, CA 93030
Phone (805) 988-2500

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

Interoperability endpoints

  • Direct secure messaging: brandin.phillips@xdr.hhchealthdirect.org
  • Direct secure messaging: phillips.brandin.nwh@direct.partners.masshiway.net

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1629473293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 THORNDIKE TER APT 2",
            "city": "SWAMPSCOTT",
            "state": "MA",
            "postal_code": "019072526",
            "telephone_number": "916-284-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 WASHINGTON ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024621607",
            "telephone_number": "617-243-6040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "351 Winchester St",
            "address_purpose": "LOCATION",
            "city": "Keene",
            "state": "NH",
            "postal_code": "034313930",
            "country_code": "US",
            "telephone_number": "603-352-3406",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1990 N California Blvd",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Walnut Creek",
            "state": "CA",
            "postal_code": "945963742",
            "country_code": "US",
            "telephone_number": "925-482-8240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "BRANDIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-24",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52101",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1340",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA8709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

Verify at the official NPI Registry.