Individual provider Active NPI

Sarietha Lanna Mathieu, NP

  • Gerontology Nurse Practitioner
  • Boston, MA
National Provider Identifier
1033727318
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN2302770 Issued in MA
Practice address
830 Harrison Ave Ste 1400
Boston, MA 02118-2905
Phone
(617) 638-8124
Fax
(617) 414-4953
NPI assigned
Jul 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN2302770 MA Primary

Addresses

Primary practice location

830 Harrison Ave Ste 1400
Boston, MA 02118-2905

Mailing address

801 Albany St FL G
Boston, MA 02119-3791

Other identifiers 1

IdentifierTypeStateIssuer
110185218AMedicaidMA

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
I20201008001763 MA Practitioner - Nurse Practitioner 9436579638 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bumc Otolaryngologic Foundation IncGroup PAC ID 2163409400, 28 clinicians
Jason Grunes PLLCGroup PAC ID 8325332729, 4 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-8485

2 Rehab Way
Woburn, MA 01801-6003
Phone (774) 270-1618

830 Harrison Ave
Suite 1400
Boston, MA 02118-2905
Phone (617) 638-8124

Hospital & facility affiliations

  • Boston Medical Center Hospital, Boston, MA, CCN 220031

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bumc Otolaryngologic Foundation, Inc. CurrentSince Apr 11, 2022 Accepting new patients
Jason Grunes PLLC CurrentSince Sep 1, 2020 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients

Locations

801 Albany St
Fl G
Roxbury, MA 02119

2 Rehabilitation Way
Woburn, MA 01801
Phone (781) 935-5050

110 Winn St
Ste 104
Woburn, MA 01801

Interoperability endpoints

  • Direct secure messaging: smathieu97401@direct.bmc.masshiway.net

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.

Hospital & facility affiliations 8

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": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1033727318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ALBANY ST FL G",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021193791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 HARRISON AVE STE 1400",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182905",
            "telephone_number": "617-638-8124",
            "fax_number": "617-414-4953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIEU",
        "first_name": "SARIETHA",
        "middle_name": "LANNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-22",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN2302770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110185218A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.