Individual provider Active NPI

Cristina Mireya Mansilla, CNP

  • Family Nurse Practitioner
  • Boston, MA
National Provider Identifier
1265151047
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2339850 Issued in MA
Practice address
1601 Washington St
Boston, MA 02118-1951
Phone
(617) 425-2000
Fax
(617) 425-2041
NPI assigned
Aug 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2339850 MA Primary

Addresses

Primary practice location

1601 Washington St
Boston, MA 02118-1951

Mailing address

1601 Washington St
Boston, MA 02118-1951
Phone (617) 425-2000

Other practice location 1

850 Harrison Ave.
Yawkey Bldg. 4th FL
Boston, MA 02118
Phone (617) 414-4363

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
I20221026002462 MA Practitioner - Nurse Practitioner 0345616702 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2339850MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medical Associates-Ebnhc CurrentSince Sep 26, 2022 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
Child Health Foundation of Boston, Inc. CurrentSince Dec 13, 2022 Accepting new patients
Neighborhealth Corporation CurrentSince Sep 26, 2022 Accepting new patients

Locations

1601 Washington St
Boston, MA 02118
Phone (617) 425-2000

850 Harrison Ave
#4
Boston, MA 02118
Phone (617) 414-2000

850 Harrison Ave
Bldg 4TH
Boston, MA 02118
Phone (617) 414-4363

10 Grove St
East Boston, MA 02128
Phone (617) 569-5800

Interoperability endpoints

  • Direct secure messaging: cmansilla14484@direct.bmc.masshiway.net

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": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1265151047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021181951",
            "telephone_number": "617-425-2000",
            "fax_number": "617-425-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021181951",
            "telephone_number": "617-425-2000",
            "fax_number": "617-425-2041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 Harrison Ave.",
            "address_2": "Yawkey Bldg. 4th FL",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02118",
            "country_code": "US",
            "telephone_number": "617-414-4363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSILLA",
        "first_name": "CRISTINA",
        "middle_name": "MIREYA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2339850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.