Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ashley M Antonellis

Individual provider Physician Assistant · NPI 1174484133

Ashley M Antonellis is a Physician Assistant in Boston, Massachusetts. Qualified in 2025, 1 year ago. Practices with Massachusetts General Physicians Organization Inc, a 3,484-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
1
Licensed in
MA
In the registry since
2025
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Practice location Address checks out

55 Fruit St
Boston, MA 02114-2621
Phone: (617) 724-3874
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA102284 (MA)

Record details

NPI number1174484133
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 19, 2025
Last updated in NPPESDecember 16, 2025
Certification dateDecember 16, 2025
Mailing address55 Fruit St, Boston, MA 02114-2621

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Massachusetts General Physicians Organization Inc — 3484 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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