Individual provider Active NPI

Rebecca L. Brown, PA

  • Physician Assistant
  • Quincy, MA
National Provider Identifier
1992899900
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1475 Issued in MA
Practice address
1261 Furnace Brook Pkwy
Quincy, MA 02169-4721
Phone
(617) 479-6333
Fax
(617) 479-4105
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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 1475 MA Primary

Addresses

Primary practice location

1261 Furnace Brook Pkwy
Quincy, MA 02169-4721

Mailing address

28 State St
Suite 2860
Boston, MA 02109-1775
Phone (617) 903-5000

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
I20051005000498 MA Practitioner - Physician Assistant 5092740324 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1475MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carney Medical Group Past Accepting new patients
Boston Medical Group, PC Past Accepting new patients
Southeast Anesthesia Assoc Past Accepting new patients
Mass General Brigham Community Physicians Inc. PastSince Feb 1, 2020 Accepting new patients

Organizations & group practices 5

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1992899900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 STATE ST",
            "address_2": "SUITE 2860",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021091775",
            "telephone_number": "617-903-5000",
            "fax_number": "617-904-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 FURNACE BROOK PKWY",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694721",
            "telephone_number": "617-479-6333",
            "fax_number": "617-479-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "REBECCA",
        "middle_name": "L.",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "1475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.