Individual provider Active NPI

Elizabeth M. Glavin, NP-C

  • Family Nurse Practitioner
  • Leominster, MA
National Provider Identifier
1265803373
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2291553 Issued in MA
Practice address
165 Mill St
Leominster, MA 01453-3289
Phone
(978) 466-3212
Fax
(978) 534-3581
NPI assigned
Oct 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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 RN2291553 MA Primary

Addresses

Primary practice location

165 Mill St
Leominster, MA 01453-3289

Mailing address

630 Plantation St
Wot 12TH FL
Worcester, MA 01605-2038
Phone (508) 368-5532

Other names 1

  • Elizabeth Frances Mellors Former name

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
I20160114001536 MA Practitioner - Nurse Practitioner 4082917604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

1250 Hancock St
Quincy, MA 02169-4339
Phone (617) 740-0600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2291553MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Current Accepting new patients
Atrius Health, Inc. CurrentSince Jun 1, 2020 Accepting new patients
Atrius Health, Inc. CurrentSince Jun 1, 2020 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

1250 Hancock St
Quincy, MA 02169
Phone (617) 774-0600

Interoperability endpoints

  • Direct secure messaging: eglavinnp321191@direct.atrius.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": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1265803373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 PLANTATION ST",
            "address_2": "WOT 12TH FL",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052038",
            "telephone_number": "508-368-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 MILL ST",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014533289",
            "telephone_number": "978-466-3212",
            "fax_number": "978-534-3581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAVIN",
        "first_name": "ELIZABETH",
        "middle_name": "M.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-15",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2291553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "MELLORS",
            "middle_name": "FRANCES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leominster, MA

Sources for this page

Verify at the official NPI Registry.