NPIMap

Individual provider Active NPI

Vincent E Paquette, M.D.

  • Internal Medicine Physician
  • Chestnut Hill, MA
National Provider Identifier
1851385389
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
48797 Issued in MA
Practice address
822 Boylston St
Suite 102
Chestnut Hill, MA 02467-2595
Phone
(617) 396-8866
Fax
(617) 505-6102
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 48797 MA Primary

Addresses

Primary practice location

822 Boylston St
Suite 102
Chestnut Hill, MA 02467-2595

Mailing address

77 Warren St
RM 339
Brighton, MA 02139
Phone (617) 562-5359

Other identifiers 1

IdentifierTypeStateIssuer
6173659MedicaidMA

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
I20050323000682 MA Practitioner - Internal Medicine 5294781233 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Revere Medical of Massachusetts PCGroup PAC ID 0749715795, 113 clinicians

Practice addresses (Care Compare)

822 Boylston St
Suite 102
Chestnut Hill, MA 02467-2504
Phone (617) 396-8866

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
48797MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Medical of Massachusetts, PC Internal Medicine CurrentSince Oct 30, 2024 Accepting new patients

Locations

11 Nevins St
Brighton, MA 02135
Phone (617) 562-2782

77 Warren St
Rm 339
Brighton, MA 02135
Phone (617) 562-5428

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

822 Boylston St
Ste 102
Chestnut Hill, MA 02467
Phone (617) 396-8866

15 Payson Rd
Ste 3
Foxboro, MA 02035
Phone (508) 772-1438

Interoperability endpoints

  • Direct secure messaging: vincent.paquette.1@32866.direct.athenahealth.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 11

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421366400000",
    "number": "1851385389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 WARREN ST",
            "address_2": "RM 339",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "02139",
            "telephone_number": "617-562-5359",
            "fax_number": "617-562-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 BOYLSTON ST",
            "address_2": "SUITE 102",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024672595",
            "telephone_number": "617-396-8866",
            "fax_number": "617-505-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAQUETTE",
        "first_name": "VINCENT",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2015-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "48797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6173659",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestnut Hill, MA

Sources for this page

Verify at the official NPI Registry.