Rebecca Joy Madjarov, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA3696 Issued in MA

Practice address

1400 VFW Pkwy
Medicine Department 111
West Roxbury, MA 02132-4927

Phone

(857) 203-5729

Fax

(857) 203-5549

NPI assigned

Sep 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1669668174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 VFW PARKWAY",
            "address_2": "MEDICINE DEPARTMENT 111",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "02132",
            "telephone_number": "857-203-5729",
            "fax_number": "857-203-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 VFW PKWY",
            "address_2": "MEDICINE DEPARTMENT 111",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021324927",
            "telephone_number": "857-203-5729",
            "fax_number": "857-203-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADJAROV",
        "first_name": "REBECCA",
        "middle_name": "JOY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA3696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Marie Mack, LICSW
• Melissa Carolyn Mackinnon, R.N.
• Douglas J Maclaren, LIC. AC.
• Robert Clarke Macmaster, RRT
• James Alexander Macneill, CRNA
• Ethel Magidson
• Lori Ann Magrath, R.D.
• Meera Mahalingam, M.D.
• Cassandra Eunice Maher, LICSW
• Lindsay M Malarky, OTR/L

• Medical Physician Assistant in West Roxbury, MA
• Providers in West Roxbury, MA by specialty
• Medical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.