Individual provider Active NPI

Juliet Vinson, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1992121420
Registry record updated Jun 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA4968 Issued in MA
Practice address
55 Fruit St
White 1
Boston, MA 02114-2621
Phone
(617) 724-4100
Fax
(617) 726-7415
NPI assigned
Mar 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2022

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 PA4968 MA Primary

Addresses

Primary practice location

55 Fruit St
White 1
Boston, MA 02114-2621

Mailing address

464 Congress Ave Ste 260
New Haven, CT 06519-1362
Phone (203) 785-4404

Other practice location 1

464 Congress Ave Ste 260
New Haven, CT 06519-1362
Phone (203) 785-4404

Other names 1

  • Juliet Wilson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20221115000718 CT Practitioner - Physician Assistant 7911123716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Sep 30, 2022 Accepting new patients
Yale University CurrentSince Sep 30, 2022 Accepting new patients

Locations

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

Interoperability endpoints

  • Direct secure messaging: jvinson586695@direct.ynhh.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654992000000",
    "number": "1992121420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 CONGRESS AVE STE 260",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191362",
            "telephone_number": "203-785-4404",
            "fax_number": "203-785-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "WHITE 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-724-4100",
            "fax_number": "617-726-7415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "464 Congress Ave Ste 260",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065191362",
            "country_code": "US",
            "telephone_number": "203-785-4404",
            "fax_number": "203-785-4580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VINSON",
        "first_name": "JULIET",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-07",
        "last_updated": "2022-06-12",
        "certification_date": "2022-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIET",
            "last_name": "WILSON",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.