Individual provider Active NPI

Nicole Perkins

  • Nurse Practitioner
  • Danvers, MA
National Provider Identifier
1053913640
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2259884 Issued in MA
Practice address
311 Newbury St
Danvers, MA 01923-1027
Phone
(978) 777-5504
NPI assigned
Nov 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2259884 MA
Nurse Practitioner 363L00000X RN2259884 MA Primary

Addresses

Primary practice location

311 Newbury St
Danvers, MA 01923-1027

Mailing address

Lahey Provider Enrollment Department 41 Mall Road
Burlington, MA 01805-0001
Phone (781) 744-8085

Other practice location 1

Lahey Clinic Inc 41 Mall Road
Burlington, MA 01805-1027
Phone (781) 744-8085

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
I20211004003034 MA Practitioner - Nurse Practitioner 3779981899 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
Telehealth
Offers telehealth services
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

1 Essex Ctr Dr
Peabody, MA 01960-2901
Phone (978) 538-4000

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2259884MAMDNurse Practitioner
2259884MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc CurrentSince Sep 29, 2021 Accepting new patients
Lahey Clinic, Inc. CurrentSince Sep 29, 2021 Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

Organizations & group practices 2

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 2

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": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1053913640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LAHEY PROVIDER ENROLLMENT DEPARTMENT 41 MALL ROAD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 NEWBURY ST",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231027",
            "telephone_number": "978-777-5504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Lahey Clinic Inc 41 Mall Road",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018051027",
            "country_code": "US",
            "telephone_number": "781-744-8085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-10",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "2259884",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2259884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

Verify at the official NPI Registry.