Individual provider Active NPI

Peter Veneziano, PA-C

  • Physician Assistant
  • Chestnut Hill, MA
National Provider Identifier
1811308554
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3996 Issued in MA
Practice address
200 Boylston St Ste A309
Chestnut Hill, MA 02467-2012
Phone
(617) 277-5000
Fax
(617) 277-5444
NPI assigned
May 15, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2020

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 PA3996 MA Primary

Addresses

Primary practice location

200 Boylston St Ste A309
Chestnut Hill, MA 02467-2012

Mailing address

200 Boylston St Ste A309
Chestnut Hill, MA 02467-2012
Phone (617) 277-5000

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
I20140725002211 MA Practitioner - Physician Assistant 8527284637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthbeat, PLLCGroup PAC ID 4385055631, 4 clinicians

Practice addresses (Care Compare)

200 Boylston St
A309
Chestnut Hill, MA 02467-2012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA3996MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lazarou Urology Associates, PC PastSince Nov 1, 2004 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1811308554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BOYLSTON ST STE A309",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024672012",
            "telephone_number": "617-277-5000",
            "fax_number": "617-277-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BOYLSTON ST STE A309",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024672012",
            "telephone_number": "617-277-5000",
            "fax_number": "617-277-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENEZIANO",
        "first_name": "PETER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-15",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA3996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestnut Hill, MA

Sources for this page

Verify at the official NPI Registry.