Individual provider Active NPI

Hannah Gasperoni

  • Medical Physician Assistant
  • Winchester, MA
National Provider Identifier
1861063158
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA8669 Issued in MA
Practice address
955 Main St Ste G6
Winchester, MA 01890-1992
Phone
(781) 729-4878
Fax
(781) 729-5989
NPI assigned
Jul 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician Assistant 363AM0700X PA8669 MA Primary

Addresses

Primary practice location

955 Main St Ste G6
Winchester, MA 01890-1992

Mailing address

136 Harrison Ave Ste 207
Boston, MA 02111-1817
Phone (617) 636-0405

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
I20240819001172 MA Practitioner - Physician Assistant 8527506849 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
Robert J Obrien Jr MD and Assoc PCGroup PAC ID 1557250586, 19 clinicians

Practice addresses (Care Compare)

140 Commonwealth Ave
Suite 201
Danvers, MA 01923-3625
Phone (781) 729-4878

955 Main St
Suite G6
Winchester, MA 01890-1992
Phone (781) 729-4878

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA8669MAMDMedical Physician Assistant

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": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1861063158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 HARRISON AVE STE 207",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111817",
            "telephone_number": "617-636-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 MAIN ST STE G6",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018901992",
            "telephone_number": "781-729-4878",
            "fax_number": "781-729-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASPERONI",
        "first_name": "HANNAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA8669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, MA

Sources for this page

Verify at the official NPI Registry.