Individual provider Active NPI

Tamar E Siracusa, APRN

  • Adult Health Nurse Practitioner
  • North Quincy, MA
National Provider Identifier
1013341163
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN2278596 Issued in MA
Practice address
110 W Squantum St
North Quincy, MA 02171-2122
Phone
(617) 376-3000
Fax
(617) 774-1905
NPI assigned
Aug 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN2278596 MA Primary
Women's Health Nurse Practitioner 363LW0102X RN2278596 MA

Addresses

Primary practice location

110 W Squantum St
North Quincy, MA 02171-2122

Mailing address

110 W Squantum St
North Quincy, MA 02171-2122
Phone (617) 376-3000

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
I20131211000592 MA Practitioner - Nurse Practitioner 6103053558 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2278596MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
The General Hospital Corporation CurrentSince Sep 13, 2017 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Sep 13, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Interoperability endpoints

  • Direct secure messaging: siracusa.tamar.mgh@direct.partners.masshiway.net

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 1

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": "1377475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1013341163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W SQUANTUM ST",
            "city": "NORTH QUINCY",
            "state": "MA",
            "postal_code": "021712122",
            "telephone_number": "617-376-3000",
            "fax_number": "617-774-1906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W SQUANTUM ST",
            "city": "NORTH QUINCY",
            "state": "MA",
            "postal_code": "021712122",
            "telephone_number": "617-376-3000",
            "fax_number": "617-774-1905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRACUSA",
        "first_name": "TAMAR",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-26",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2278596",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "RN2278596",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Quincy, MA

Sources for this page

Verify at the official NPI Registry.