Active NPI
Samuel Duarte
- Physician Assistant
- Boston, MA
National Provider Identifier
1730958778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 136 Harrison Ave
M&V Room 510a
Boston, MA 02111 - Phone
- (203) 631-1789
- NPI assigned
- Jan 1, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
136 Harrison Ave
M&V Room 510a
Boston, MA 02111
Mailing address
136 Harrison Avenue
M&V Room 510a
Boston, MA 02111
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
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.
-
- Cardiovascular Disease Physician
- Boston, MA
- NPI 1447764253
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704067200000",
"number": "1730958778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "136 HARRISON AVENUE",
"address_2": "M&V ROOM 510A",
"city": "BOSTON",
"state": "MA",
"postal_code": "02111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 HARRISON AVE",
"address_2": "M&V ROOM 510A",
"city": "BOSTON",
"state": "MA",
"postal_code": "02111",
"telephone_number": "203-631-1789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUARTE",
"first_name": "SAMUEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-01-01",
"last_updated": "2024-01-01",
"certification_date": "2023-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2024; 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.