NPIMap

Individual provider Active NPI

Rebecca Larosa, NP

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1134610280
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2321745 Issued in MA
Practice address
55 Fruit St
Bul 2
Boston, MA 02114-2621
Phone
(176) 437-9726
NPI assigned
May 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2321745 MA Primary
Registered Nurse 163W00000X RN2321745 MA

Addresses

Primary practice location

55 Fruit St
Bul 2
Boston, MA 02114-2621

Mailing address

14 Winthrop Rd
Chelsea, MA 02150-1120

Other practice location 1

1 Hospital Rd
Oak Bluffs, MA 02557-1406
Phone (508) 693-0410

Other names 1

  • Rebecca Lysiak Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211209002258 MA Practitioner - Nurse Practitioner 4284024050 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Martha'S Vineyard Hospital IncGroup PAC ID 9931166113, shared by 5 NPIs, 150 clinicians

Practice addresses (Care Compare)

1 Hospital Rd
Oak Bluffs, MA 02557-1406
Phone 508693041079525

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2321745MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc CurrentSince Nov 1, 2021 Accepting new patients
Martha'S Vineyard Hospital, Inc. Current Accepting new patients
Martha'S Vineyard Hospital, Inc. CurrentSince Jul 1, 2023 Accepting new patients
The General Hospital Corporation CurrentSince Nov 1, 2021 Accepting new patients
Martha'S Vineyard Hospital, Inc. CurrentSince Jul 1, 2023 Accepting new patients
General Hospital Corp Current Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

1 Hospital Rd
Oak Bluffs, MA 02557
Phone (508) 684-4500

Interoperability endpoints

  • Direct secure messaging: lysiak.rebecca.mgh@direct.partners.masshiway.net

Organizations & group practices 6

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 5

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": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1134610280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WINTHROP RD",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "021501120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "BUL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "176-437-9726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Oak Bluffs",
            "state": "MA",
            "postal_code": "025571406",
            "country_code": "US",
            "telephone_number": "508-693-0410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAROSA",
        "first_name": "REBECCA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-24",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2321745",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2321745",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "LYSIAK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.