Individual provider Active NPI

Yi Zhang, GNP

  • Gerontology Nurse Practitioner
  • Waltham, MA
National Provider Identifier
1083763908
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
206717 Issued in MA
Practice address
950 Winter St
Suite 3800
Waltham, MA 02451-1424
Phone
(781) 472-8796
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 206717 MA Primary

Addresses

Primary practice location

950 Winter St
Suite 3800
Waltham, MA 02451-1424

Mailing address

16 Welch Rd
Lexington, MA 02421-7519
Phone (781) 472-8796

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
I20150507000813 MA Order and Referring Only - Nurse Practitioner 2769701085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
206717MAMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083763908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 WELCH RD",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024217519",
            "telephone_number": "781-472-8796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 WINTER ST",
            "address_2": "SUITE 3800",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511424",
            "telephone_number": "781-472-8796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHANG",
        "first_name": "YI",
        "credential": "GNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "206717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.