Daniel J Clemente, PA
Individual provider Active NPI Physician Assistant · Auburn, MA
NPI 1629830641 · NPPES record last updated Nov 11, 2024
Key facts
- NPI
- 1629830641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA100646 (MA)
- Practice address
- 4 Brotherton Way
Auburn, MA 01501-2684 - Phone
- (508) 721-1199
- Fax
- (508) 453-8019
- NPI assigned
- Jan 25, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Reliant Medical Group Inc
Practice addresses (Care Compare)
5 Neponset St
Worcesteer, MA 01606-2714
Phone (508) 595-2300
900 Union St
Westborough, MA 01581-5408
Phone (508) 366-8836
Hospital & facility affiliations
- Milford Regional Medical Center
- Umass Memorial Medical Center/University Campus
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240521002050 | MA | Practitioner - Physician Assistant | 4880036987 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA100646 | MA | Yes |
Addresses
Primary practice location
4 Brotherton Way
Auburn, MA 01501-2684
Mailing address
4 Brotherton Way
Auburn, MA 01501-2684
Phone (508) 721-1199
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110210279A | Medicaid | MA |
Other providers in Auburn, MA
- Alicia Chestna
- Child Health Associates
- Child Health Associates
- James Clark
- Sean Patrick Cleary
- Cmipa Foundation, Inc.
- Jeffrey Lucash Cohn
- Michael J Cohn
- Helen L. Collette
- Kristin Collins
All providers in Auburn, MA · Physician Assistant in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.