Laura Boldyrev
Individual provider Active NPI Family Nurse Practitioner · Cambridge, MA
NPI 1235528696 · NPPES record last updated Nov 14, 2019
Key facts
- NPI
- 1235528696
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN2269857 (MA)
- Practice address
- 300 Mount Auburn St
Suite 509
Cambridge, MA 02138-5600 - Phone
- (617) 576-3350
- Fax
- (617) 576-6422
- NPI assigned
- Jan 22, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mount Auburn Professional Services Inc
Practice addresses (Care Compare)
300 Mount Auburn St
Cambridge, MA 02138-5600
Phone (617) 499-5025
Hospital & facility affiliations
- Mount Auburn Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150615001636 | MA | Practitioner - Nurse Practitioner | 7810208030 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2269857 | MA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mt Auburn Professional Services | Current |
Accepting new patients | |
| Mount Auburn Professional Services Inc | Current |
Accepting new patients |
Locations
300 Mount Auburn St
Ste 509
Cambridge, MA 02138
Phone (617) 576-3350
300 Mount Auburn St
Cambridge, MA 02138
Phone (617) 499-5025
57 Bedford St
Ste 130
Lexington, MA 02420
Phone (781) 484-7500
Interoperability endpoints
- lboldyrev253717@direct.bilh.masshiway.net
- https://api.platform.athenahealth.com/86/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN2269857 | MA | Yes |
Addresses
Primary practice location
300 Mount Auburn St
Suite 509
Cambridge, MA 02138-5600
Mailing address
300 Mount Auburn St
Suite 509
Cambridge, MA 02138-5600
Phone (617) 576-3350
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | leboldyr@mah.harvard.edu |
Other providers in Cambridge, MA
- Marjorie Bogdanow
- Kathryn Dingman Boger
- Catherin Alexis Bohn
- Kathleen Michelle Boland
- Bold Psych, LLC
- Bryan Bollinger
- Sarah Katherine Bolte
- Daniel D Bolton
- Meg Alison Bond
- Frantz Boneau
All providers in Cambridge, MA · Family Nurse Practitioner in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.