Individual provider Active NPI

Mary Pappalardo-Raymond, PNP

  • Pediatric Nurse Practitioner
  • Woburn, MA
National Provider Identifier
1174770754
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
168304 Issued in MA
Practice address
7 Alfred St
Balwin Park II
Woburn, MA 01801-1976
Phone
(781) 933-6236
Fax
(781) 938-8050
NPI assigned
Aug 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 168304 MA Primary

Addresses

Primary practice location

7 Alfred St
Balwin Park II
Woburn, MA 01801-1976

Mailing address

7 Alfred St
Balwin Park II
Woburn, MA 01801-1976
Phone (781) 933-6236

Other names 1

  • Mrs. Mary P Pappalardo Raymond Other name

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
I20220624002427 MA Practitioner - Nurse Practitioner 7517346323 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
168304MAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. CurrentSince Jun 1, 2022 Accepting new patients
Atrius Health, Inc. Current Accepting new patients
Atrius Health, Inc. CurrentSince Jun 1, 2022 Accepting new patients
Woburn Pediatric Associates Past Accepting new patients
North Andover Pediatric Associates Past Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
Boston, MA 02109
Phone (617) 421-2508

Interoperability endpoints

  • Direct secure messaging: mraymond18360@direct.chppoc.masshiway.net
  • Direct secure messaging: mpappalardoraymondnp347128@direct.atrius.masshiway.net

Organizations & group practices 5

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": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1174770754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ALFRED ST",
            "address_2": "BALWIN PARK II",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011976",
            "telephone_number": "781-933-6236",
            "fax_number": "781-938-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 ALFRED ST",
            "address_2": "BALWIN PARK II",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011976",
            "telephone_number": "781-933-6236",
            "fax_number": "781-938-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPPALARDO-RAYMOND",
        "first_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-26",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "168304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "PAPPALARDO RAYMOND",
            "middle_name": "P",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Woburn, MA

Sources for this page

Verify at the official NPI Registry.