Individual provider Active NPI

Gina Elisabetta Ouellette

  • Emergency Medical Services (Emergency Medicine) Physician
  • Concord, MA
National Provider Identifier
1114895711
Registry record updated Oct 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
RN2325436 Issued in MA
Practice address
133 Ornac
Concord, MA 01742-4159
Phone
(978) 369-1400
NPI assigned
Oct 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X RN2325436 MA Primary

Addresses

Primary practice location

133 Ornac
Concord, MA 01742-4159

Mailing address

18 Sunset Rd
Dracut, MA 01826-2440

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
I20260430000636 MA Practitioner - Nurse Practitioner 7113494873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emerson Emergency Physicians LLCGroup PAC ID 9931253838, 5 clinicians

Practice addresses (Care Compare)

133 Old Rd to 9 Acre Cor
Concord, MA 01742-4159
Phone (978) 287-3694

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2325436MAMDEmergency Medical Services (Emergency Medicine) Physician

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": "1761350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761350400000",
    "number": "1114895711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 SUNSET RD",
            "city": "DRACUT",
            "state": "MA",
            "postal_code": "018262440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 ORNAC",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017424159",
            "telephone_number": "978-369-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUELLETTE",
        "first_name": "GINA",
        "middle_name": "ELISABETTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-25",
        "last_updated": "2025-10-25",
        "certification_date": "2025-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MA",
            "license": "RN2325436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

Verify at the official NPI Registry.