Individual provider Active NPI

Catherine D Elie, FNP

  • Family Nurse Practitioner
  • Tewksbury, MA
National Provider Identifier
1023079373
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
151127 Issued in MA
Practice address
1574 Main St
Tewksbury, MA 01876-2067
Phone
(978) 323-2819
Fax
(978) 323-2820
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 151127 MA Primary

Addresses

Primary practice location

1574 Main St
Tewksbury, MA 01876-2067

Mailing address

1574 Main St
Tewksbury, MA 01876-2067
Phone (978) 323-2819

Other identifiers 1

IdentifierTypeStateIssuer
M15184OtherMABCBSMA NUMBER

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
I20060123000714 MA Practitioner - Nurse Practitioner 4880618305 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
151127MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
LGH Medical Group, Inc. CurrentSince May 26, 2015 Accepting new patients
LGH Professional Services LLC Past Accepting new patients
Merrimack Family Medicine PC Past Accepting new patients

Locations

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

170 Main St
Unit G06
Tewksbury, MA 01876
Phone (978) 851-4141

1574 Main St
Ste 200
Tewksbury, MA 01876
Phone (978) 323-2819

Interoperability endpoints

  • Direct secure messaging: celie27057@tuftsmedicine.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1023079373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1574 MAIN ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018762067",
            "telephone_number": "978-323-2819",
            "fax_number": "978-323-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1574 MAIN ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018762067",
            "telephone_number": "978-323-2819",
            "fax_number": "978-323-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIE",
        "first_name": "CATHERINE",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "151127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMA NUMBER",
            "identifier": "M15184",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tewksbury, MA

Sources for this page

Verify at the official NPI Registry.