Active NPI
Annette Marie Grace, NP
- Pediatric Nurse Practitioner
- Quincy, MA
National Provider Identifier
1285608760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 129706
- Practice address
- 1250 Hancock St
Quincy, MA 02169-4339 - Phone
- (617) 774-0600
- NPI assigned
- Feb 14, 2006
- Last updated
- Mar 7, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 129706 | MA | |
| Pediatric Nurse Practitioner | 363LP0200X | 129706 | MA | Primary |
Addresses
Primary practice location
1250 Hancock St
Quincy, MA 02169-4339
Mailing address
1250 Hancock St
Quincy, MA 02169-4339
Phone (617) 774-0600
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0380661 | Medicaid | MA | |
| PF367 | Other | MA | HARVARD PILGRIM |
| NP9999 | Other | MA | BLUE CROSS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | agracenp4640@direct.atrius.masshiway.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Interoperability endpoints
- agracenp4640@direct.atrius.masshiway.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615075200000",
"number": "1285608760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 HANCOCK ST",
"city": "QUINCY",
"state": "MA",
"postal_code": "021694339",
"telephone_number": "617-774-0600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 HANCOCK ST",
"city": "QUINCY",
"state": "MA",
"postal_code": "021694339",
"telephone_number": "617-774-0600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRACE",
"first_name": "ANNETTE",
"middle_name": "MARIE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-14",
"last_updated": "2021-03-07",
"certification_date": "2021-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "129706",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MA",
"license": "129706",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0380661",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "PF367",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "NP9999",
"state": "MA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "agracenp4640@direct.atrius.masshiway.net",
"affiliation": "N",
"address_1": "1250 Hancock St",
"city": "Quincy",
"state": "MA",
"country_code": "US",
"postal_code": "021694339",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Quincy, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.