Individual provider Active NPI

Ellena A Diggins, PAC

  • Physician Assistant
  • Jamaica Plain, MA
National Provider Identifier
1649326158
Registry record updated Jan 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
333 Issued in MA
Practice address
170 Morton St
Jamaica Plain, MA 02130-3735
Phone
(617) 522-8110
Fax
(617) 971-3852
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2016

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 333 MA Primary

Addresses

Primary practice location

170 Morton St
Jamaica Plain, MA 02130-3735

Mailing address

170 Morton St
Jamaica Plain, MA 02130-3735
Phone (617) 971-3768

Other identifiers 1

IdentifierTypeStateIssuer
333OtherMAPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
333MAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1649326158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MORTON ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303735",
            "telephone_number": "617-971-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MORTON ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303735",
            "telephone_number": "617-522-8110",
            "fax_number": "617-971-3852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIGGINS",
        "first_name": "ELLENA",
        "middle_name": "A",
        "name_prefix": "Miss",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA",
            "identifier": "333",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

Verify at the official NPI Registry.