Individual provider Active NPI

Kathryn Elizabeth Liziewski

  • Nurse Practitioner
  • Lexington, MA
National Provider Identifier
1063129757
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2346935 Issued in MA
Practice address
24 Hartwell Ave
Lexington, MA 02421-3132
Phone
(781) 862-3899
NPI assigned
Nov 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2346935 MA Primary

Addresses

Primary practice location

24 Hartwell Ave
Lexington, MA 02421-3132

Mailing address

119 Ridge LN Apt 302
Waltham, MA 02452-4994
Phone (202) 272-5568

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
I20230110002472 MA Practitioner - Nurse Practitioner 1850761701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Massachusetts Medical School, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Care of Boston Management CorporationGroup PAC ID 6800787714, 293 clinicians

Practice addresses (Care Compare)

464 Hillside Ave
Suite 302
Needham, MA 02494-1228
Phone (781) 449-5170

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2346935MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care of Boston Management Corporation CurrentSince Dec 23, 2022 Accepting new patients

Locations

24 Hartwell Ave
Ste 204
Lexington, MA 02421
Phone (781) 862-3800

24 Hartwell Ave
Lexington, MA 02421
Phone (781) 862-3899

464 Hillside Ave
Ste 302
Needham, MA 02494
Phone (781) 444-1129

93 Pond St
Sharon, MA 02067
Phone (781) 784-9212

247 Station Dr
Ste NW1
Westwood, MA 02090
Phone (617) 754-1015

Interoperability endpoints

  • Direct secure messaging: kliziewski255550@direct.bilh.masshiway.net

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 4

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": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1063129757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 RIDGE LN APT 302",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024524994",
            "telephone_number": "202-272-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 HARTWELL AVE",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024213132",
            "telephone_number": "781-862-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZIEWSKI",
        "first_name": "KATHRYN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-01",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2346935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

Verify at the official NPI Registry.