Individual provider Active NPI

Kristy Luker, NP

  • Family Nurse Practitioner
  • Boston, MA
National Provider Identifier
1104648427
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2346918 Issued in MA
Practice address
55 Fruit Street
Boston, MA 02114
Phone
(617) 726-2000
NPI assigned
Oct 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2346918 MA
Family Nurse Practitioner 363LF0000X RN2346918 MA Primary

Addresses

Primary practice location

55 Fruit Street
Boston, MA 02114

Mailing address

3 Appleton Street
Apt 501
Boston, MA 02116
Phone (860) 818-4056

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
I20250130001799 MA Practitioner - Nurse Practitioner 9234668641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Suburban Gastroenterology PCGroup PAC ID 9931194412, 50 clinicians

Practice addresses (Care Compare)

97 Libbey Pkwy
Suite 300
Weymouth, MA 02189-3110
Phone (781) 331-2922

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2346918MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
South Suburban Gastroenterology, PC CurrentSince Feb 24, 2025 Accepting new patients
Weymouth Endoscopy, LLC PastSince Feb 24, 2025 Accepting new patients

Locations

1085 Main St
Weymouth, MA 02190
Phone (781) 331-2922

97 Libbey Park
Ste 300
Weymouth, MA 02189
Phone (781) 331-2922

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 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": "1730073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1104648427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 APPLETON STREET",
            "address_2": "APT 501",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02116",
            "telephone_number": "860-818-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKER",
        "first_name": "KRISTY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-28",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2346918",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2346918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.