Individual provider Active NPI

Lijimol Biju

  • Family Nurse Practitioner
  • Cambridge, MA
National Provider Identifier
1285230888
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN261144 Issued in MA
Practice address
36 White Street
Cambridge, MA 02140-0214
Phone
(617) 876-5519
NPI assigned
Dec 9, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2020066953 MA
Family Nurse Practitioner 363LF0000X RN261144 MA Primary

Addresses

Primary practice location

36 White Street
Cambridge, MA 02140-0214

Mailing address

36 White Street
Cambridge, MA 02140
Phone (617) 876-5519

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
I20220811001581 MA Practitioner - Nurse Practitioner 9931582756 Reassigns benefits to 2 organizations

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
360 Healthcare LLCGroup PAC ID 5597131532, 30 clinicians

Practice addresses (Care Compare)

10 Mall Rd
Suite 305
Burlington, MA 01803-4121
Phone (781) 488-6843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2020066953MAMDFamily Nurse Practitioner
RN261144MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Medical Plus CurrentSince Jul 1, 2022 Accepting new patients
360 Healthcare LLC CurrentSince Sep 12, 2024 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

10 Mall Rd
Ste 305
Burlington, MA 01803

10 Mall Rd
Ste 301
Burlington, MA 01803
Phone (781) 488-6843

3 Allied Dr
Dedham, MA 02026
Phone (404) 587-0945

585 Lebanon St
Melrose, MA 02176
Phone (781) 979-3026

750 Woburn St
Wilmington, MA 01887
Phone (781) 488-6843

Organizations & group practices 2

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": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1285230888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 WHITE STREET",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02140",
            "telephone_number": "617-876-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 WHITE STREET",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021400214",
            "telephone_number": "617-876-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIJU",
        "first_name": "LIJIMOL",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-09",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "2020066953",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN261144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.