Individual provider Active NPI

Bryanna Ali Matias-Parham

  • Physician Assistant
  • Worcester, MA
National Provider Identifier
1992583702
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA101780 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(774) 441-6468
NPI assigned
Sep 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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 PA101780 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other practice location 1

119 Belmont St
Worcester, MA 01605-2903
Phone (774) 441-6468

Other identifiers 1

IdentifierTypeStateIssuer
110224513AMedicaidMA

Other names 1

  • Bryanna Ali Matias Former name

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
I20250918004052 MA Practitioner - Physician Assistant 5991209264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

119 Belmont St
Worcester, MA 01605-2903
Phone (508) 334-1000

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

  • Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA101780MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group, Inc. CurrentSince Oct 1, 2025 Accepting new patients
Umass Memorial Medical Group Inc Physician Assistant CurrentSince Oct 1, 2025 Accepting new patients

Locations

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345

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 1

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": "1695254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1992583702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "774-441-6468"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 Belmont St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052903",
            "country_code": "US",
            "telephone_number": "774-441-6468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATIAS-PARHAM",
        "first_name": "BRYANNA",
        "middle_name": "ALI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-21",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA101780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110224513A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRYANNA",
            "last_name": "MATIAS",
            "middle_name": "ALI",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.