Individual provider Active NPI

Elise Jun Zhou

  • Psychiatric/Mental Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1255066932
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2351350 Issued in MA
Practice address
1 Devonshire PL Apt 2011
Boston, MA 02109-3514
Phone
(978) 505-3132
NPI assigned
Jul 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2351350 MA Primary

Addresses

Primary practice location

1 Devonshire PL Apt 2011
Boston, MA 02109-3514

Mailing address

1 Devonshire PL Apt 2011
Boston, MA 02109-3514
Phone (978) 505-3132

Other identifiers 1

IdentifierTypeStateIssuer
100211037583MedicaidMA

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
I20231127003167 MA Practitioner - Nurse Practitioner 5395193676 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
Group practices
Child and Family Psychological Services PLLCGroup PAC ID 5991763823, 260 clinicians

Practice addresses (Care Compare)

185 Devonshire St
Suite 801
Boston, MA 02110-1407
Phone (617) 259-1895

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2351350MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychological Services, PLLC CurrentSince Oct 1, 2023 Accepting new patients

Locations

185 Devonshire St
Ste 801
Boston, MA 02110

89 Access Rd
Ste 24
Norwood, MA 02062
Phone (781) 336-5040

169 Libbey Park
Weymouth, MA 02189
Phone (508) 238-7766

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.elisejunzhou@147611.advancedmd-direct.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.

NPI Registry JSON

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1255066932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DEVONSHIRE PL APT 2011",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021093514",
            "telephone_number": "978-505-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DEVONSHIRE PL APT 2011",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021093514",
            "telephone_number": "978-505-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHOU",
        "first_name": "ELISE",
        "middle_name": "JUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-18",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2351350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100211037583",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.