Individual provider Active NPI

Rielly Jodoin Malz, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1801639406
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
260 Tremont St
Boston, MA 02116-5603
Phone
(617) 636-5000
NPI assigned
Jun 13, 2024
Last updated
Oct 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

260 Tremont St
Boston, MA 02116-5603

Mailing address

260 Tremont St
Boston, MA 02116-5603
Phone (617) 636-5000

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
I20240712003664 MA Practitioner - Physician Assistant 6800331919 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians
Pratt Medical Group IncGroup PAC ID 3375515661, 282 clinicians

Practice addresses (Care Compare)

245 Hartford Ave
Bellingham, MA 02019-3007
Phone (774) 295-4355

40 Davis Straits
Falmouth, MA 02540-3906
Phone (774) 255-3010

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

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Convenientmd - FFS UC LLC CurrentSince Jul 1, 2024 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Jul 1, 2024 Accepting new patients
Pratt Medical Group, Inc CurrentSince Sep 29, 2025 Accepting new patients
Pratt Medical Group, Inc Past Accepting new patients

Locations

245 Hartford Ave
Bellingham, MA 02019
Phone (774) 295-4355

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

40 Davis Straits
Falmouth, MA 02540
Phone (774) 255-3010

987 Main St
Weymouth, MA 02190
Phone (781) 927-3000

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

Organizations & group practices 6

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 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": "1718236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1801639406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 TREMONT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165603",
            "telephone_number": "617-636-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 TREMONT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165603",
            "telephone_number": "617-636-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALZ",
        "first_name": "RIELLY",
        "middle_name": "JODOIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-13",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.