Individual provider Active NPI

Paul Kiprotich Langat

  • Psychiatric/Mental Health Nurse Practitioner
  • Revere, MA
National Provider Identifier
1023546058
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2304081 Issued in MA
Practice address
230 Revere St Apt 2
Revere, MA 02151-4603
Phone
(857) 413-9238
NPI assigned
Jun 4, 2017
Last updated
Jun 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2304081 MA Primary
Primary Care Nurse Practitioner 363LP2300X AG07230203 MA
Registered Nurse 163W00000X RN2304081 MA

Addresses

Primary practice location

230 Revere St Apt 2
Revere, MA 02151-4603

Mailing address

394 Ocean Ave Apt 315
Revere, MA 02151-2672
Phone (857) 413-9238

Other practice location 1

11 River St
Wellesley, MA 02481-2017
Phone (781) 431-1177

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
I20231115000713 MA Practitioner - Nurse Practitioner 4880041771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthdrive Behavioral Health Services, PLLCGroup PAC ID 8729345822, 89 clinicians

Practice addresses (Care Compare)

100 Crossing Blvd
Suite 300
Framingham, MA 01702-5555
Phone (888) 964-6681

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2304081MAMDPsychiatric/Mental Health Nurse Practitioner
AG07230203MAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthdrive Behavioral Health Services, PLLC Psychiatric/Mental Health CurrentSince Oct 23, 2023 Accepting new patients

Locations

100 Crossing Blvd
Ste 300
Framingham, MA 01702
Phone (857) 255-0486

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1496534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1023546058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "394 OCEAN AVE APT 315",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021512672",
            "telephone_number": "857-413-9238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 REVERE ST APT 2",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021514603",
            "telephone_number": "857-413-9238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 River St",
            "address_purpose": "LOCATION",
            "city": "Wellesley",
            "state": "MA",
            "postal_code": "024812017",
            "country_code": "US",
            "telephone_number": "781-431-1177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANGAT",
        "first_name": "PAUL",
        "middle_name": "KIPROTICH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-04",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2304081",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "AG07230203",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2304081",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Revere, MA

Sources for this page

Verify at the official NPI Registry.