Individual provider Active NPI

Peter Johnson

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1063277465
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2354716 Issued in MA
Practice address
1340 Boylston St
Boston, MA 02215-4302
Phone
(617) 267-0900
NPI assigned
Feb 15, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2354716 MA
Nurse Practitioner 363L00000X RN2354716 MA Primary

Addresses

Primary practice location

1340 Boylston St
Boston, MA 02215-4302

Mailing address

124 Ocean Ave Apt 307
Salem, MA 01970-2990
Phone (508) 317-1944

Other practice location 1

269 Union St
Lynn, MA 01901-1314
Phone (781) 596-2502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1340 Boylston St
Boston, MA 02215-4302

75 Federal St FL
Suite 7
Boston, MA 02110-1913

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2354716MAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1063277465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 OCEAN AVE APT 307",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702990",
            "telephone_number": "508-317-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 BOYLSTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022154302",
            "telephone_number": "617-267-0900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "269 Union St",
            "address_purpose": "LOCATION",
            "city": "Lynn",
            "state": "MA",
            "postal_code": "019011314",
            "country_code": "US",
            "telephone_number": "781-596-2502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PETER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-15",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2354716",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2354716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.