NPIMap

Individual provider Active NPI

Aleksandra Maia Bacon, A-GNP-C

  • Primary Care Nurse Practitioner
  • Lynn, MA
National Provider Identifier
1245950708
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN2330670 Issued in MA
Practice address
37 Friend St
Lynn, MA 01902-3068
Phone
(978) 513-7300
NPI assigned
Sep 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Primary Care Nurse Practitioner 363LP2300X RN2330670 MA Primary

Addresses

Primary practice location

37 Friend St
Lynn, MA 01902-3068

Mailing address

30 Polk St Unit 303
Charlestown, MA 02129-1995
Phone (802) 343-1986

Other practice location 1

30 Polk St Unit 303
Charlestown, MA 02129-1995
Phone (180) 234-3198

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241219003992 VT Practitioner - Nurse Practitioner 2769919331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Vermont Medical Center IncGroup PAC ID 3779491071, 1,208 clinicians

Practice addresses (Care Compare)

62 Tilley Dr
Suite 201
South Burlington, VT 05403-4407
Phone (802) 847-3737

Hospital & facility affiliations

  • Univ. of Vermont - Fletcher Allen Health Care Hospital, Burlington, VT, CCN 470003
  • Porter Hospital Inc Hospital, Middlebury, VT, CCN 471307
  • Central Vermont Medical Center Hospital, Barre, VT, CCN 470001
  • Northwestern Medical Center Inc Hospital, Saint Albans, VT, CCN 470024
  • The University of Vermont Health Network - Champl Hospital, Plattsburgh, NY, CCN 330250

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2330670MAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc CurrentSince Dec 1, 2024 Accepting new patients

Locations

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

62 Tilley Dr
Ste 201
South Burlington, VT 05403
Phone (802) 847-3737

Interoperability endpoints

  • Direct secure messaging: abacon604154@direct.uvmhealth.org
  • Direct secure messaging: aleksandra.bacon.p1@direct.elementcare.nextgenshare.com

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.

Hospital & facility affiliations 21

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1245950708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 POLK ST UNIT 303",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021291995",
            "telephone_number": "802-343-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 FRIEND ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019023068",
            "telephone_number": "978-513-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Polk St Unit 303",
            "address_purpose": "LOCATION",
            "city": "Charlestown",
            "state": "MA",
            "postal_code": "021291995",
            "country_code": "US",
            "telephone_number": "180-234-3198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACON",
        "first_name": "ALEKSANDRA",
        "middle_name": "MAIA",
        "name_prefix": "Mrs.",
        "credential": "A-GNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "RN2330670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.