Individual provider Active NPI

Paul Benjamin Waksman, PA-C

  • Medical Physician Assistant
  • Sandwich, MA
National Provider Identifier
1679034003
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA8561 Issued in MA
Practice address
18 Route 6a
Sandwich, MA 02563-5309
Phone
(508) 775-8282
Fax
(508) 775-8280
NPI assigned
Mar 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA8561 MA Primary

Addresses

Primary practice location

18 Route 6a
Sandwich, MA 02563-5309

Mailing address

130 North St Ste a
Hyannis, MA 02601-3825
Phone (508) 775-8282

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
I20220309002707 MA Practitioner - Physician Assistant 6800205535 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, 1,432 clinicians

Practice addresses (Care Compare)

860 Route 134
South Dennis, MA 02660-2577
Phone (508) 385-4212

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.43 of 100Reported as group
Quality
91.1
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA8561MAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Cod Orthopedics and Sports Medicine PC CurrentSince Feb 17, 2024 Accepting new patients

Locations

130 North St
Ste A
Hyannis, MA 02601
Phone (508) 775-8282

130 North St
Hyannis, MA 02601
Phone (508) 775-8282

18 Route 6A
Apt 2
Sandwich, MA 02563
Phone (508) 771-4691

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1679034003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 NORTH ST STE A",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013825",
            "telephone_number": "508-775-8282",
            "fax_number": "508-775-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 ROUTE 6A",
            "city": "SANDWICH",
            "state": "MA",
            "postal_code": "025635309",
            "telephone_number": "508-775-8282",
            "fax_number": "508-775-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKSMAN",
        "first_name": "PAUL",
        "middle_name": "BENJAMIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-28",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA8561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandwich, MA

Sources for this page

Verify at the official NPI Registry.