Individual provider Active NPI

Perry Elizabeth Blank, FNP-BC

  • Family Nurse Practitioner
  • Boston, MA
National Provider Identifier
1255958823
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2328889 Issued in MA
Practice address
394 Harrison Ave
Boston, MA 02118-2212
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Jun 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2328889 MA
Family Nurse Practitioner 363LF0000X RN2328889 MA Primary

Addresses

Primary practice location

394 Harrison Ave
Boston, MA 02118-2212

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723

Other practice location 1

28 State St Ste 2860
Boston, MA 02109-1789
Phone (617) 903-5000

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
I20220927002378 MA Practitioner - Nurse Practitioner 7315323425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mass General Brigham Community Physicians IncGroup PAC ID 1759273436, 430 clinicians

Practice addresses (Care Compare)

53 State St
Suite 106
Boston, MA 02109-2820
Phone (617) 903-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2328889MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Community Physicians Inc. Current Accepting new patients
Mass General Brigham Community Physicians Inc CurrentSince Jun 6, 2022 Accepting new patients
Mass General Brigham Community Physicians Inc. CurrentSince Jun 6, 2022 Accepting new patients
Davis Square Family Practice PastSince Jun 1, 2021 Accepting new patients

Locations

185 Dartmouth St
Ste 603
Boston, MA 02116
Phone (617) 224-5351

28 State St
Ste 2860
Boston, MA 02109

53 State St
Ste 106
Boston, MA 02109

394 Harrison Ave
Boston, MA 02118

399 Revolution Dr
Ste 1010
Somerville, MA 02145
Phone (857) 282-2063

Organizations & group practices 4

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": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1255958823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "394 HARRISON AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182212",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28 State St Ste 2860",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021091789",
            "country_code": "US",
            "telephone_number": "617-903-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANK",
        "first_name": "PERRY",
        "middle_name": "ELIZABETH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2328889",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2328889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.