Individual provider Active NPI

Heena Nissaraly, DNP, RN, AGNP-C

  • Nurse Practitioner
  • Jamaica Plain, MA
National Provider Identifier
1013890433
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AG07250146 Issued in MA
Practice address
3297 Washington St
Jamaica Plain, MA 02130-2655
Phone
(617) 522-4700
NPI assigned
Jul 31, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2349337 MA
Nurse Practitioner 363L00000X AG07250146 MA Primary

Addresses

Primary practice location

3297 Washington St
Jamaica Plain, MA 02130-2655

Mailing address

3297 Washington St
Jamaica Plain, MA 02130-2655
Phone (617) 763-3518

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
I20260303000359 MA Practitioner - Nurse Practitioner 8426530270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brigham and Womens Hospital IncGroup PAC ID 4385554732, 52 clinicians

Practice addresses (Care Compare)

3297 Washington St
Boston, MA 02130-2655
Phone (617) 732-6039

Hospital & facility affiliations

  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2349337MAMDRegistered Nurse
AG07250146MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Hospital, Inc. CurrentSince Feb 20, 2026 Accepting new patients

Organizations & group practices 1

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": "1753920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1013890433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3297 WASHINGTON ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302655",
            "telephone_number": "617-763-3518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3297 WASHINGTON ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302655",
            "telephone_number": "617-522-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISSARALY",
        "first_name": "HEENA",
        "credential": "DNP, RN, AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-31",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2349337",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "AG07250146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

Verify at the official NPI Registry.