NPIMap

Individual provider Active NPI

Taryn Persia Lacasse, PA-C

  • Physician Assistant
  • Dover, NH
National Provider Identifier
1679854798
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1875 Issued in NH
Practice address
789 Central Ave
Dover, NH 03820-2526
Phone
(603) 742-8787
Fax
(603) 740-2446
NPI assigned
Sep 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA4224 MA
Medical Physician Assistant 363AM0700X 1875 NH
Physician Assistant 363A00000X 1875 NH Primary

Addresses

Primary practice location

789 Central Ave
Dover, NH 03820-2526

Mailing address

PO Box 412503
Boston, MA 02241-2503
Phone (617) 726-3884

Other practice location 1

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Other identifiers 1

IdentifierTypeStateIssuer
110121445AMedicaidMA

Other names 1

  • Taryn Brin Persia Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 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
I20120106000233 MA Practitioner - Physician Assistant 8224204615 Reassigns benefits to 3 organizations
I20220914001473 NH Practitioner - Physician Assistant 8224204615 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

450 Brookline Ave
Boston, MA 02215-5418
Phone (617) 632-3000

789 Central Ave
Dover, NH 03820-2526

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1875NHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Hospital Current Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince May 15, 2017 Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Sep 19, 2022 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Aug 21, 2024 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince May 15, 2017 Accepting new patients
Westchester Neurological Consultant PC Past Accepting new patients

Locations

450 Brookline Ave
#D1B30
Boston, MA 02215
Phone (617) 582-8431

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
Boston, MA 02114

75 Francis St
Boston, MA 02115

450 Brookline Ave
#204
Boston, MA 02215
Phone (617) 632-3252

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

121 Corporate Dr
Bldg C
Portsmouth, NH 03801
Phone (603) 740-8787

121 Corporate Dr
Ste 200
Portsmouth, NH 03801
Phone (603) 610-8075

67 Corporate Dr
#300
Portsmouth, NH 03801
Phone (603) 516-0092

Interoperability endpoints

  • Direct secure messaging: persia.taryn.wdh@direct.partners.masshiway.net
  • Direct secure messaging: persia.taryn.dfci@direct.partners.masshiway.net
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1679854798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412503",
            "telephone_number": "617-726-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-742-8787",
            "fax_number": "603-740-2446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156110",
            "country_code": "US",
            "telephone_number": "617-732-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACASSE",
        "first_name": "TARYN",
        "middle_name": "PERSIA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-01",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA4224",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NH",
            "license": "1875",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110121445A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARYN",
            "last_name": "PERSIA",
            "middle_name": "BRIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.