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

Individual provider Physician Assistant · NPI 1033760657

Kelly R Wisniewski, PA-C is a Physician Assistant in Boston, Massachusetts. Qualified in 2019, 7 years ago. Practices with Brigham and Womens Physicians Organization Inc, a 2,916-clinician group and accepts Medicare assignment.

Years since qualifying
7
In the registry since
2019
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

75 Francis St
Boston, MA 02115-6110
Phone: (617) 732-5636
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1033760657
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 25, 2019
Last updated in NPPESFebruary 5, 2020
Certification dateFebruary 5, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Brigham And Womens Physicians Organization Inc — 2916 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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