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Please refer to the Full Licensure Application (DOC) for detailed instructions.
An official Physician Assistant Information Profile from the FCVS may be submitted in lieu of transcripts and NCCPA documentation. If you are registered with FCVS and are using this service for your application, please inform the Board. For more information about the FCVS Profile, visit the FCVS web site.
Submit verification of your licensure status, in signed, sealed envelopes, from any state or jurisdiction in which you now or have ever held any professional license or board certification. Verifications must be sent directly to the Board by the state or other jurisdictions. Note: If verifications have been previously submitted with an application for a temporary practice certificate, they do not need to be resubmitted if they were issued within the past 12 months.
You must request a National Practitioner Data Bank-Healthcare Integrity and Protection Data Bank Self-Query and submit the Original report in a signed and sealed envelope with this application. To request a Self Query, please contact the National Practitioner Data Bank online or at (800) 767-6732. Keep a copy for your records.
Check or money order payable to:The Commonwealth of Massachusetts
Cash or foreign currency is not accepted.
Note: If you hold a Temporary Practice Certificate, you must pay this fee in addition to the fee previously paid for your Temporary Practice Certificate.
Mail all required materials and fee payment to:
Bureau of Health Professions LicensureBoard of Registration of Physician Assistants
239 Causeway St.
Boston, MA 02114
For further information, please contact the Board office at (800) 414-0168 or (617) 973-0806.