Individual provider Active NPI

Nicole Marie Yaxter, FNP-C

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1194579698
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2325789 Issued in MA
Practice address
1 Deaconess Rd
Boston, MA 02215-5321
Phone
(617) 667-7000
NPI assigned
Apr 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2325789 MA
Nurse Practitioner 363L00000X RN2325789 MA Primary

Addresses

Primary practice location

1 Deaconess Rd
Boston, MA 02215-5321

Mailing address

24 Westdale Rd
Canton, MA 02021-1345
Phone (617) 922-7438

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
I20250307001235 MA Practitioner - Nurse Practitioner 0749701621 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr IncGroup PAC ID 4486567104, shared by 12 NPIs, 1,693 clinicians

Practice addresses (Care Compare)

1 Deaconess Rd
Boston, MA 02215-5321
Phone (781) 983-9088

330 Brookline Ave
Boston, MA 02215-5400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2325789MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Aug 1, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Feb 19, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Feb 19, 2025 Accepting new patients

Locations

1 Deaconess Rd
Boston, MA 02215
Phone (617) 754-2323

110 Francis St
Ste 3A
Boston, MA 02215
Phone (617) 632-9780

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

Organizations & group practices 3

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": "1712880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1194579698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 WESTDALE RD",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020211345",
            "telephone_number": "617-922-7438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DEACONESS RD",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155321",
            "telephone_number": "617-667-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAXTER",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-12",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2325789",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2325789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.