Individual provider Active NPI

Lizanne C Noble, NP

  • Adult Health Nurse Practitioner
  • Wellesley Hills, MA
National Provider Identifier
1245572205
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN2270707 Issued in MA
Practice address
65 Walnut St
Ste 480
Wellesley Hills, MA 02481-2118
Phone
(781) 431-7733
Fax
(781) 235-2665
NPI assigned
Mar 18, 2013
Last updated
Apr 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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 RN2270707 MA Primary

Addresses

Primary practice location

65 Walnut St
Ste 480
Wellesley Hills, MA 02481-2118

Mailing address

65 Walnut St
Ste 480
Wellesley Hills, MA 02481-2118
Phone (781) 431-7733

Other identifiers 1

IdentifierTypeStateIssuer
043064615OtherTAX ID

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
I20131009000039 MA Practitioner - Nurse Practitioner 5597999409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Partners IncGroup PAC ID 0840386249, 7 clinicians

Practice addresses (Care Compare)

65 Walnut St
Suite 480
Wellesley Hills, MA 02481-2195
Phone (781) 431-7733

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2270707MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Partners Inc CurrentSince May 2, 2016 Accepting new patients

Locations

65 Walnut St
Ste 480
Wellesley Hls, MA 02481
Phone (781) 431-7733

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1245572205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 WALNUT ST",
            "address_2": "STE 480",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024812118",
            "telephone_number": "781-431-7733",
            "fax_number": "781-235-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 WALNUT ST",
            "address_2": "STE 480",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024812118",
            "telephone_number": "781-431-7733",
            "fax_number": "781-235-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "LIZANNE",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-18",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2270707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "043064615",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley Hills, MA

Sources for this page

Verify at the official NPI Registry.