Individual provider Active NPI

Linda Coughlin Debeasi, RN/NP

  • Primary Care Nurse Practitioner
  • Boston, MA
National Provider Identifier
1063791069
Registry record updated Aug 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN151745 Issued in MA
Practice address
330 Brookline Ave
Shapiro Clinical Center, 6TH Floor.
Boston, MA 02215-5400
Phone
(617) 667-9600
NPI assigned
Aug 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X RN151745 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Shapiro Clinical Center, 6TH Floor.
Boston, MA 02215-5400

Mailing address

330 Brookline Ave
Shapiro Clinical Center, 6TH Floor.
Boston, MA 02215-5400

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
I20111108000625 MA Practitioner - Nurse Practitioner 3375716368 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN151745MAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Oct 3, 2011 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Oct 3, 2011 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Oct 3, 2011 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Oct 3, 2011 Accepting new patients

Locations

330 Brookline Ave
Fl 6
Boston, MA 02215
Phone (617) 754-9600

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

1 University Ave
Westwood, MA 02090
Phone (617) 754-1021

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

Interoperability endpoints

  • Direct secure messaging: linda.debeasi.npi1063791069.reliant@direct.optumcare.masshiway.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1063791069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "SHAPIRO CLINICAL CENTER, 6TH FLOOR.",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "SHAPIRO CLINICAL CENTER, 6TH FLOOR.",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBEASI",
        "first_name": "LINDA",
        "middle_name": "COUGHLIN",
        "credential": "RN/NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-08",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "RN151745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.