Katherine A. Ladetto, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

216965 Issued in MA

Practice address

55 Fruit Street
MGH Gastroenterology Associates Blake 4
Boston, MA 02114-2696

Phone

(617) 643-5763

Fax

(617) 724-6832

NPI assigned

Apr 9, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1063685212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT STREET",
            "address_2": "MGH GASTROENTEROLOGY ASSOCIATES BLAKE 4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-643-5763",
            "fax_number": "617-724-6832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT STREET",
            "address_2": "MGH GASTROENTEROLOGY ASSOCIATES BLAKE 4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-643-5763",
            "fax_number": "617-724-6832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADETTO",
        "first_name": "KATHERINE",
        "middle_name": "A.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "216965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MA",
            "identifier": "NP4153",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI BLUE CHIP",
            "identifier": "412009",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0701033",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly Lauren Lacy, M.D.
• Roseanne Lacy
• Kingsley Ladega
• Vinicius Ladeira Craveiro, M.D.
• Mary Erin Ladesic, DNP, APRN, FNP-BC
• Feria Ladha, MD, PHD
• Karim Ladha, M.D.
• Naila Ladha, DMD
• James L Ladner, M.D.
• Jared Ladouceur

• Nurse Practitioner in Boston, MA
• Providers in Boston, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.