Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly Neligan Fucillo, PA-C, MPAS

Individual provider Physician Assistant · NPI 1619493376

Kelly Neligan Fucillo, PA-C, MPAS is a Physician Assistant in Boston, Massachusetts. Licensed in Massachusetts. Registered with an NPI since 2017.

Licensed in
MA
In the registry since
2017
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

55 Fruit St
Boston, MA 02114-2621
Phone: (617) 724-2844
Fax: (617) 726-5804
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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 PA6259 (MA)

Record details

NPI number1619493376
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C , MPAS
Sole proprietorNo
NPI enumeratedAugust 15, 2017
Last updated in NPPESSeptember 23, 2020
Certification dateSeptember 23, 2020

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