Individual provider Active NPI

Brenda McKeon, NP

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1245308139
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
201762 Issued in MA
Practice address
150 S Huntington Ave
Boston, MA 02130-4817
Phone
(617) 638-6100
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 201762 MA Primary

Addresses

Primary practice location

150 S Huntington Ave
Boston, MA 02130-4817

Mailing address

150 S Huntington Ave
Boston, MA 02130-4817
Phone (857) 364-2692

Medicare participation

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201762MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Evans Geriatric Section of Evans PastSince Aug 1, 2018 Accepting new patients
Evans Medical Foundation, Inc. Past 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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1245308139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "857-364-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "617-638-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEON",
        "first_name": "BRENDA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "201762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.