Individual provider Active NPI

Haili Dunbar, PA-C

  • Physician Assistant
  • Quincy, MA
National Provider Identifier
1821535964
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA6074 Issued in MA
Practice address
1690 Crown Colony Dr
Quincy, MA 02169-0913
Phone
(914) 907-4379
NPI assigned
Jan 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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 PA6074 MA Primary

Addresses

Primary practice location

1690 Crown Colony Dr
Quincy, MA 02169-0913

Mailing address

77 Adams St Unit 502
Quincy, MA 02169-2027
Phone (914) 907-4379

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
I20170927000369 MA Practitioner - Physician Assistant 6204100464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tufts Medical Center Community Care IncGroup PAC ID 4981915659, 21 clinicians

Practice addresses (Care Compare)

1690 Crown Colony Dr
Quincy, MA 02169-0913
Phone (857) 403-4600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA6074MAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: hdunbar29701@tuftsmedicine.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1485475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1821535964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 ADAMS ST UNIT 502",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021692027",
            "telephone_number": "914-907-4379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 CROWN COLONY DR",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021690913",
            "telephone_number": "914-907-4379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNBAR",
        "first_name": "HAILI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-27",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA6074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.