NPIMap

Individual provider Active NPI

Patrick Thomas Cooke, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1821640608
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
55 Fruit St
Boston, MA 02114-2696
Phone
(617) 726-2000
NPI assigned
Jul 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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 Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2696

Mailing address

5 Lamontagne LN
Rutland, VT 05701-3781
Phone (802) 353-2545

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://patientgateway.partners.org/login/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191028000530 MA Practitioner - Physician Assistant 4981936838 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

102 Endicott St
MGH North Shore Medical
Danvers, MA 01923-3623
Phone (978) 882-6100

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Martha'S Vineyard Hospital, Inc. CurrentSince Sep 11, 2023 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Oct 1, 2019 Accepting new patients
Martha'S Vineyard Hospital, Inc. CurrentSince Sep 11, 2023 Accepting new patients
General Hospital Corp Current Accepting new patients
Martha'S Vineyard Hospital Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

104 Endicott St
Ste 200B
Danvers, MA 01923
Phone (857) 238-3838

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

1 Hospital Rd
Oak Bluffs, MA 02557
Phone (508) 684-4500

Interoperability endpoints

  • Direct secure messaging: cooke.patrick.mgh@direct.partners.masshiway.net

Organizations & group practices 8

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 6

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": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1821640608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LAMONTAGNE LN",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057013781",
            "telephone_number": "802-353-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-726-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "PATRICK",
        "middle_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-11",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://patientgateway.partners.org/login/",
            "affiliation": "N",
            "address_1": "55 Fruit St",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021142696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.