Individual provider Active NPI

Nancy Hartley Walenski, NP

  • Primary Care Nurse Practitioner
  • Jamaica Plain, MA
National Provider Identifier
1205918935
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN136600 Issued in MA
Practice address
150 S Huntington Ave
Buidling 9-HBPC
Jamaica Plain, MA 02130-4817
Phone
(857) 364-6758
Fax
(857) 364-4162
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X RN136600 MA Primary

Addresses

Primary practice location

150 S Huntington Ave
Buidling 9-HBPC
Jamaica Plain, MA 02130-4817

Mailing address

150 S Huntington Ave
Building 9- HBPC
Jamaica Plain, MA 02130-4817
Phone (857) 364-6758

Other identifiers 1

IdentifierTypeStateIssuer
0342670MedicaidMA

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
I20170414000019 MA Order and Referring Only - Nurse Practitioner 6800831280

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care of Boston Management Corporation Past Accepting new patients

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1205918935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "address_2": "BUILDING 9- HBPC",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "857-364-6758",
            "fax_number": "857-364-4162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "address_2": "BUIDLING 9-HBPC",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "857-364-6758",
            "fax_number": "857-364-4162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLEY WALENSKI",
        "first_name": "NANCY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "RN136600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0342670",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

Verify at the official NPI Registry.