Dorisanne Yllena Wonsor, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA7386 Issued in MA

Practice address

450 Brookline Ave
Boston, MA 02215-5450

Phone

(516) 473-4989

NPI assigned

Jun 30, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dorisanne Ylena Ragon Former name

Medicare fee-for-service enrollment

Enrolled in VT

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southwestern Vermont Medical Center, IncGroup PAC ID 0143138446, 174 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southwestern Vermont Medical Center Hospital, Bennington, VT, CCN 470012
• Rutland Regional Medical Center Hospital, Rutland, VT, CCN 470005

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dorisanne.wonsor.1@3744.direct.athenahealth.com

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.

• Southwestern Vermont Medical Center Inc.

  • Internal Medicine Physician
  • Bennington, VT
  • NPI 1184994162
  Medicare reassignment Care Compare group NPD
• Southwestern Vermont Medical Center Inc.

  • General Acute Care Hospital
  • Bennington, VT
  • NPI 1205865789
  NPD

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

• Rutland Hospital, Inc.

  dba Rutland Regional Medical Center

  • General Acute Care Hospital
  • Rutland, VT
  • NPI 1720042203
  Care Compare affiliation
• Southwestern Vermont Medical Center Inc.

  • General Acute Care Hospital
  • Bennington, VT
  • NPI 1205865789
  Care Compare affiliation

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

{
    "created_epoch": "1561852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1710549761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SHANLEY ST APT 1",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155450",
            "telephone_number": "516-473-4989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 Shanley St Apt 1",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021353137",
            "country_code": "US",
            "telephone_number": "516-473-4989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONSOR",
        "first_name": "DORISANNE",
        "middle_name": "YLLENA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-30",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA7386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DORISANNE",
            "last_name": "RAGON",
            "middle_name": "YLENA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wai Y Wong, M.D.
• Waichi Wong, MD
• Janewit Wongboonsin
• Pootipong Wongveerasin, M.D.
• Olivia Brooke Wons, PHD
• Caitlin Susanne Woo-Pierce, M.D.
• Taylor Ann Woo-Sekizaki
• Amanda Woo, MD, MPH
• Barbara J Woo, MD
• Beverly Woo, MD

• Physician Assistant in Boston, MA
• Providers in Boston, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.