Individual provider Active NPI

Rosanne K Buck, RN MS NNP-BC

  • Critical Care Neonatal Nurse Practitioner
  • Boston, MA
National Provider Identifier
1255584272
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
128093 Issued in MA
Practice address
330 Brookline Ave
Boston, MA 02215
Phone
(617) 667-4042
Fax
(617) 667-7793
NPI assigned
Nov 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN128093 MA
Critical Care Neonatal Nurse Practitioner 363LN0005X 128093 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Boston, MA 02215

Mailing address

330 Brookline Ave
Beth Israel Deaconess Medical Center Nicu
Boston, MA 02215
Phone (617) 667-4042

Other practice location 1

123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-7449

Other practice location 2

119 Belmont St
Worcester, MA 01605-2903
Phone (508) 334-6206

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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
I20220311000660 MA Practitioner - Nurse Practitioner 6406241322 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
128093MAMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group, Inc. CurrentSince Mar 2, 2022 Accepting new patients
Umass Memorial Medical Group Inc Nurse Practitioner CurrentSince Mar 2, 2022 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients

Locations

119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

Organizations & group practices 3

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": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1255584272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "BETH ISRAEL DEACONESS MEDICAL CENTER NICU",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-667-4042",
            "fax_number": "617-667-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-667-4042",
            "fax_number": "617-667-7793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Summer St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016081216",
            "country_code": "US",
            "telephone_number": "508-363-7449",
            "fax_number": "508-363-7512",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "119 Belmont St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052903",
            "country_code": "US",
            "telephone_number": "508-334-6206",
            "fax_number": "508-334-6083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCK",
        "first_name": "ROSANNE",
        "middle_name": "K",
        "credential": "RN MS NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN128093",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "MA",
            "license": "128093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "119 Belmont St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.