Individual provider Active NPI

Kathryn E Quinn, NP

  • Family Nurse Practitioner
  • Boston, MA
National Provider Identifier
1114248408
Registry record updated Sep 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2261394 Issued in MA
Practice address
830 Harrison Ave
Moakley, 3Rd Floor
Boston, MA 02118
Phone
(617) 638-6428
Fax
(617) 638-5756
NPI assigned
Jun 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2261394 MA Primary

Addresses

Primary practice location

830 Harrison Ave
Moakley, 3Rd Floor
Boston, MA 02118

Mailing address

720 Harrison Ave
Dob 503
Boston, MA 02118-2371

Other identifiers 1

IdentifierTypeStateIssuer
110090798AMedicaidMA

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
I20101104001023 MA Practitioner - Nurse Practitioner 0547454431 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2261394MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
First Psychiatric Planners, Inc CurrentSince Dec 1, 2014 Accepting new patients

Locations

300 South St
Chestnut Hill, MA 02467
Phone (617) 469-0300

Organizations & group practices 1

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": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506384000000",
    "number": "1114248408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 HARRISON AVE",
            "address_2": "MOAKLEY, 3RD FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-638-6428",
            "fax_number": "617-638-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "KATHRYN",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-21",
        "last_updated": "2017-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2261394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110090798A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.