Individual provider Active NPI

Krista Reis, P.A.C.

  • Surgical Physician Assistant
  • Stoneham, MA
National Provider Identifier
1770534117
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1710 Issued in MA
Practice address
92 Montvale Ave
Ste 3000
Stoneham, MA 02180-3647
Phone
(781) 438-6350
Fax
(781) 279-0430
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1710 MA
Surgical Physician Assistant 363AS0400X 1710 MA Primary

Addresses

Primary practice location

92 Montvale Ave
Ste 3000
Stoneham, MA 02180-3647

Mailing address

92 Montvale Ave
Ste 3000
Stoneham, MA 02180-3647
Phone (781) 438-6350

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
I20160502001431 MA Practitioner - Physician Assistant 3779882477 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Pratt Orthopaedic Associates IncGroup PAC ID 7618295437, 29 clinicians

Practice addresses (Care Compare)

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

Hospital & facility affiliations

  • Melrosewakefield Healthcare Hospital, Melrose, MA, CCN 220070

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1710MAMDSurgical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: kreis28880@tuftsmedicine.direct-ci.com

Organizations & group practices 2

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 1

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1770534117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 MONTVALE AVE",
            "address_2": "STE 3000",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803647",
            "telephone_number": "781-438-6350",
            "fax_number": "781-279-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 MONTVALE AVE",
            "address_2": "STE 3000",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803647",
            "telephone_number": "781-438-6350",
            "fax_number": "781-279-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIS",
        "first_name": "KRISTA",
        "credential": "P.A.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "1710",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "1710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoneham, MA

Sources for this page

Verify at the official NPI Registry.