Individual provider Active NPI

Lauren Puia

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1184968265
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209-009940 Issued in IL
Practice address
290 Huntington Ave # Sb112
Boston, MA 02115-5018
Phone
(617) 585-1284
Fax
(617) 585-1208
NPI assigned
Nov 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 209009940 IL
Nurse Practitioner 363L00000X 209-009940 IL Primary

Addresses

Primary practice location

290 Huntington Ave # Sb112
Boston, MA 02115-5018

Mailing address

290 Huntington Ave # Sb112
Boston, MA 02115-5018
Phone (617) 585-1284

Other identifiers 2

IdentifierTypeStateIssuer
RN250838OtherMALICENSE
209009940OtherILLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Advanced Practice Nurse

State licenses

LicenseStateTypeSpecialty
209009940ILMDGeneral Practice Registered Nurse
209-009940ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New England Conservatory PastSince Mar 19, 2023 Accepting new patients
Rush University Medical Group PastSince Apr 27, 2014 Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1184968265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 HUNTINGTON AVE # SB112",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155018",
            "telephone_number": "617-585-1284",
            "fax_number": "617-585-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 HUNTINGTON AVE # SB112",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155018",
            "telephone_number": "617-585-1284",
            "fax_number": "617-585-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUIA",
        "first_name": "LAUREN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "IL",
            "license": "209009940",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-009940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN250838",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "209009940",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.