Individual provider Active NPI

Ellen Diana Klee, NP

  • Adult Health Nurse Practitioner
  • Medford, MA
National Provider Identifier
1013206572
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN265967 Issued in MA
Practice address
170 Governors Ave
Lawrence Memorial Hospital-Diabetes Center
Medford, MA 02155-1643
Phone
(781) 306-6370
Fax
(781) 306-6375
NPI assigned
Apr 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN265967 MA Primary

Addresses

Primary practice location

170 Governors Ave
Lawrence Memorial Hospital-Diabetes Center
Medford, MA 02155-1643

Mailing address

170 Governors Ave
Lawrence Memorial Hospital-Diabetes Center
Medford, MA 02155-1643
Phone (781) 306-6370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110613000853 MA Practitioner - Nurse Practitioner 2961689286 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hallmark Health Medical Associates IncGroup PAC ID 4385638782, 151 clinicians

Practice addresses (Care Compare)

170 Governors Ave
Medford, MA 02155-1643

425 Revere St
Revere, MA 02151-4543
Phone (781) 665-6606

585 Lebanon St
Melrose, MA 02176-3225
Phone (781) 979-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN265967MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hallmark Health Medical Associates Inc Adult Health CurrentSince Mar 1, 2015 Accepting new patients
Hallmark Health System Inc CurrentSince Jun 1, 2011 Accepting new patients
Melrosewakefield Healthcare, Inc. CurrentSince Jun 1, 2011 Accepting new patients
Melrosewakefield Healthcare, Inc. Current Accepting new patients

Locations

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

170 Governors Ave
Ste 100
Medford, MA 02155
Phone (617) 277-1205

425 Revere St
Revere, MA 02151
Phone (781) 286-1313

Interoperability endpoints

  • Direct secure messaging: eklee21638@tuftsmedicine.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365552000000",
    "number": "1013206572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 GOVERNORS AVE",
            "address_2": "LAWRENCE MEMORIAL HOSPITAL-DIABETES CENTER",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021551643",
            "telephone_number": "781-306-6370",
            "fax_number": "781-306-6375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 GOVERNORS AVE",
            "address_2": "LAWRENCE MEMORIAL HOSPITAL-DIABETES CENTER",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021551643",
            "telephone_number": "781-306-6370",
            "fax_number": "781-306-6375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEE",
        "first_name": "ELLEN",
        "middle_name": "DIANA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2013-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN265967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.