Individual provider Active NPI

Ana Maldonado, PA-C/MPH

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1881676849
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1406 Issued in MA
Practice address
7 Haviland St
Boston, MA 02115-2683
Phone
(617) 927-6117
Fax
(617) 536-8602
NPI assigned
Nov 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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 1406 MA Primary

Addresses

Primary practice location

7 Haviland St
Boston, MA 02115-2683

Mailing address

PO Box 1870
Watsonville, CA 95077-1870
Phone (831) 728-0222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200213002711 CA Practitioner - Physician Assistant 1254480809 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21550CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Para la Gente CurrentSince Dec 20, 2020 Accepting new patients
Salud Para la Gente CurrentSince Dec 20, 2020 Accepting new patients

Locations

45 Nielson St
Watsonville, CA 95076
Phone (831) 761-1588

195 Aviation Way
Ste 200
Watsonville, CA 95076

204 E Beach St
Watsonville, CA 95076
Phone (831) 763-3413

Organizations & group practices 3

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1881676849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1870",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950771870",
            "telephone_number": "831-728-0222",
            "fax_number": "831-707-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 HAVILAND ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021152683",
            "telephone_number": "617-927-6117",
            "fax_number": "617-536-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "ANA",
        "name_prefix": "Ms.",
        "credential": "PA-C/MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "1406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.