PAUL S DESILLIER (NPI# 1013903152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013903152 |
| Entity Type | Individual |
| Full Name | PAUL S DESILLIER |
| Credential | PAC |
| Practice Address |
300 Mount Auburn St Suite 505 Cambridge MA 02138-5600 |
| Practice Telephone | 6174916766 |
| Mailing Telephone | 6174916766 |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2008-11-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1784 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
300 MOUNT AUBURN ST SUITE 505 |
| City | CAMBRIDGE |
| State | MA |
| Zip Code | 02138-5600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568466316 | Frederick W Ruymann | Internal Medicine | 300 Mount Auburn St, Ste 405, Cambridge, MA 02138-5665 | 2005-06-09 |
| 1134688120 | Peymaan Sam Banankhah | Internal Medicine | 300 Mount Auburn St, Cambridge, MA 02138-5600 | 2019-03-18 |
| 1508389636 | Emily Holmes | Nurse Practitioner | 300 Mount Auburn St, Cambridge, MA 02138-5600 | 2017-07-20 |
| 1396277455 | Dr. Susan Pories | Surgery | 300 Mount Auburn St, Suite 509, Cambridge, MA 02138-5600 | 2017-03-29 |
| 1992243554 | Allison Vandermeulen | Specialist/Technologist, Other | 300 Mount Auburn St, Suite 505, Cambridge, MA 02138-5600 | 2017-02-03 |
| 1982142519 | Jessica Jeanne Sullivan | Registered Nurse | 300 Mount Auburn St, Cambridge, MA 02138-5600 | 2017-02-02 |
| 1578017497 | Andrew Dallahan Donnelly | Registered Nurse | 300 Mount Auburn St, Suite 517, Cambridge, MA 02138-5600 | 2016-08-09 |
| 1447634670 | Troy Tweiten | Internal Medicine | 300 Mount Auburn St, Cambridge, MA 02138-5600 | 2015-07-17 |
| 1235528696 | Laura Boldyrev | Nurse Practitioner | 300 Mount Auburn St, Suite 509, Cambridge, MA 02138-5600 | 2015-01-22 |
| 1649673724 | Cambridge Digestive Health PC | Internal Medicine | 300 Mount Auburn St, Suite 405, Cambridge, MA 02138-5600 | 2014-10-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618610 | Khushboo Vijay Bhatia | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Program, Mount Auburn Hospi, 330 Mt. Auburn Street, Cambridge, MA 02138 | 2020-08-06 |
| 1780204156 | Ashna Grover | Student in an Organized Health Care Education/Training Program | 330 Mt Auburn Street Mount Auburn Hospital, Internal Medicine Residency Program, Cambridge, MA 02138 | 2020-04-25 |
| 1790330298 | Cambridge Periodontics LLC | Dentist | 1692 Massachusetts Ave Ste 3, Cambridge, MA 02138 | 2019-08-02 |
| 1295389765 | Yulia Levit | Technician/Technologist | 1208 Massachussets Av, Cambridge, MA 02138 | 2019-08-01 |
| 1720645393 | Chinmay Tusharkumar Jani | Student in an Organized Health Care Education/Training Program | Mount Auburn Hospital, 330 Mt Auburn Street, Cambridge, MA 02138 | 2019-05-20 |
| 1386209831 | Alexander Ryan Walker | Internal Medicine | 300 Mount Auburn Street Mount Auburn Hospital, Dept. of Medicine, Cambridge, MA 02138 | 2019-05-09 |
| 1659844868 | Aimee Hsieh | Social Worker | 525 Mount Auburn Street, Cambridge, MA 02138 | 2019-01-10 |
| 1043733389 | Armida Fruzzetti | Psychologist | 900 Concord Avenue, Cambridge, MA 02138 | 2017-07-19 |
| 1174984827 | Jenna Mezin Schmid | Psychologist | 75 Mt Auburn St 4 East, Harvard University Health Services, Cambridge, MA 02138 | 2016-03-09 |
| 1316313208 | Kelly Abbott | Optometrist | 12 Eliot St., Cambridge, MA 02138 | 2015-08-14 |
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| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043827058 | Anupa Manjunatha | Physician Assistant | 33 Rogers St Apt 210, Cambridge, MA 02142-1516 | 2020-09-24 |
| 1083263594 | Katherine Lemons | Physician Assistant | 6 Crawford St Apt 10, Cambridge, MA 02139-1644 | 2019-09-06 |
| 1790346674 | Heather Ann Borden | Physician Assistant | 87 New St Unit 207, Cambridge, MA 02138-1287 | 2019-06-22 |
| 1902331408 | Celia Alexandra Charlois | Physician Assistant | 169 Monsignor Obrien Hwy, Apt 805, Cambridge, MA 02141-1289 | 2017-04-22 |
| 1609244078 | Shawna Young | Physician Assistant | 817 Main St N, Cambridge, MN 55008-1275 | 2015-09-02 |
| 1518304567 | Samantha L Elich | Physician Assistant | 1435 Cambridge Street, Cambridge, MA 02139-1047 | 2013-05-31 |
| 1912239468 | Jeffrey Eric Stark | Physician Assistant | 35 Gilbert Street, Cambridge Medical Center, Cambridge, NY 12816-2618 | 2010-02-09 |
| 1902418411 | Emily Grace Yanico | Physician Assistant | 1330 Clark St, Cambridge, OH 43725-9614 | 2020-08-18 |
| 1043833221 | Nicholas D Gottshall | Physician Assistant | 330 Mount Auburn St, Cambridge, MA 02138-5502 | 2020-05-22 |
| 1760029342 | Christina Leahy | Physician Assistant | 1493 Cambridge St, Cambridge, MA 02139-1099 | 2019-12-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.