Individual provider Active NPI

Brett Everett Ekstrom, FNP-C

  • Primary Care Nurse Practitioner
  • Hudson, MA
National Provider Identifier
1104335900
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN2280502 Issued in MA
Practice address
1 Cabot Rd Ste 101
Hudson, MA 01749-2963
Phone
(785) 623-5369
NPI assigned
Sep 25, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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 RN2280502 MA Primary

Addresses

Primary practice location

1 Cabot Rd Ste 101
Hudson, MA 01749-2963

Mailing address

171 Main St Ste 203B
Ashland, MA 01721-1187
Phone (508) 881-3029

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Ekstrom.Brett.CRM@direct.partners.masshiway.net

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
I20180123000529 MA Practitioner - Nurse Practitioner 9133488000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

246 Maple St
Marlborough, MA 01752-3235
Phone (508) 460-3872

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2280502MAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charles River Medical Associates PC CurrentSince Jan 1, 2018 Accepting new patients
Charles River Medical Associates PC CurrentSince Jan 1, 2018 Accepting new patients

Locations

171 Main St
Ste 203B
Ashland, MA 01721
Phone (508) 881-3029

600 Worcester Rd
Ste 504
Framingham, MA 01702
Phone (508) 875-0922

1 Cabot Rd
Ste 101
Hudson, MA 01749
Phone (978) 562-3536

246 Maple St
Marlborough, MA 01752
Phone (508) 460-3872

Interoperability endpoints

  • Direct secure messaging: ekstrom.brett.crm@direct.partners.masshiway.net

Organizations & group practices 2

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 4

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": "1506297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1104335900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 MAIN ST STE 203B",
            "city": "ASHLAND",
            "state": "MA",
            "postal_code": "017211187",
            "telephone_number": "508-881-3029",
            "fax_number": "508-881-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CABOT RD STE 101",
            "city": "HUDSON",
            "state": "MA",
            "postal_code": "017492963",
            "telephone_number": "785-623-5369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKSTROM",
        "first_name": "BRETT",
        "middle_name": "EVERETT",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-25",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "RN2280502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ekstrom.Brett.CRM@direct.partners.masshiway.net",
            "affiliation": "N",
            "address_1": "1 Cabot Rd Ste 101",
            "city": "Hudson",
            "state": "MA",
            "country_code": "US",
            "postal_code": "017492963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hudson, MA

Sources for this page

Verify at the official NPI Registry.