Individual provider Active NPI

Libby Rose Levine, FNP

  • Nurse Practitioner
  • Brighton, MA
National Provider Identifier
1083489876
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2279436 Issued in MA
Practice address
11 Nevins St
Suite 306
Brighton, MA 02135-3514
Phone
(617) 789-2045
Fax
(617) 789-2045
NPI assigned
Nov 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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 RN2279436 MA Primary

Addresses

Primary practice location

11 Nevins St
Suite 306
Brighton, MA 02135-3514

Mailing address

960 Massachusetts Avenue
FL 2
Boston, MA 02118-2690

Other practice location 1

535 Faunce Corner Road
Dartmouth, MA 02747
Phone (617) 789-2045

Other identifiers 1

IdentifierTypeStateIssuer
110207123AMedicaidMA

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
I20240318000349 MA Practitioner - Nurse Practitioner 6406293190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9 Galen St
Suite 155
Watertown, MA 02472-4523

960 Massachusetts Ave
Boston, MA 02118-2690

960 Massachusetts Ave
Suite 2
Boston, MA 02118-2620

Hospital & facility affiliations

  • Boston Medical Center-Brighton Hospital, Brighton, MA, CCN 220036

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Feb 6, 2024 Accepting new patients
BMC Affiliated Physicians, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Steward Medical Group, Inc CurrentSince Feb 6, 2024 Accepting new patients

Locations

960 Massachusetts Ave
Ste 2
Boston, MA 02118

11 Nevins St
Ste 306
Brighton, MA 02135
Phone (617) 789-2045

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

535 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 961-0665

Interoperability endpoints

  • Direct secure messaging: libby.levine.1@2017.direct.athenahealth.com
  • Direct secure messaging: llevine259808@direct.bmc.masshiway.net

Organizations & group practices 3

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 1

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": "1700524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1083489876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVENUE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 NEVINS ST",
            "address_2": "SUITE 306",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353514",
            "telephone_number": "617-789-2045",
            "fax_number": "617-789-2045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 Faunce Corner Road",
            "address_purpose": "LOCATION",
            "city": "Dartmouth",
            "state": "MA",
            "postal_code": "02747",
            "country_code": "US",
            "telephone_number": "617-789-2045",
            "fax_number": "617-779-6760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "LIBBY",
        "middle_name": "ROSE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-21",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2279436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110207123A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.