Individual provider Active NPI

Amy Catherlene Israelian, APRN, BC

  • Adult Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1205961497
Registry record updated Nov 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
252113 Issued in MA
Practice address
55 Fruit St
Wacc, Suite 435
Boston, MA 02114-2621
Phone
(617) 726-2000
Fax
(617) 726-8089
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 252113 MA Primary

Addresses

Primary practice location

55 Fruit St
Wacc, Suite 435
Boston, MA 02114-2621

Mailing address

55 Fruit St
Wacc, Suite 435
Boston, MA 02114-2621
Phone (617) 726-2000

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
I20160406002051 MA Practitioner - Nurse Practitioner 1254378268 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2014 Washington St
Newton, MA 02462-1607
Phone (617) 243-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
252113MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nantucket Cottage Hospital CurrentSince Jan 17, 2016 Accepting new patients
Nantucket Cottage Hospital CurrentSince Jan 17, 2016 Accepting new patients
Newton Wellesley Hospital Current Accepting new patients
Mass General Brigham Medical Group Suburban Massachusetts Inc CurrentSince Apr 10, 2019 Accepting new patients
Compass Medical PC Past Accepting new patients

Locations

55 Fruit St
Ste 435
Boston, MA 02114

57 Prospect St
Nantucket, MA 02554
Phone (508) 228-1200

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

Interoperability endpoints

  • Direct secure messaging: israelian.amy.nwh@direct.partners.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.

Hospital & facility affiliations 1

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1205961497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "WACC, SUITE 435",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-2000",
            "fax_number": "617-726-8089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "WACC, SUITE 435",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-2000",
            "fax_number": "617-726-8089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISRAELIAN",
        "first_name": "AMY",
        "middle_name": "CATHERLENE",
        "name_prefix": "Ms.",
        "credential": "APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "252113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.