Individual provider Active NPI

Andrea Grace Cristina Yegiazaryan, MS, BSN, RN, CPNP-PC

  • Pediatric Nurse Practitioner
  • Waltham, MA
National Provider Identifier
1316329402
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN269529 Issued in MA
Practice address
9 Hope Ave
Waltham, MA 02453-2741
Phone
(781) 216-1500
NPI assigned
Jun 24, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN269529 MA Primary

Addresses

Primary practice location

9 Hope Ave
Waltham, MA 02453-2741

Mailing address

300 Longwood Ave
Boston, MA 02115-5737
Phone (617) 355-6000

Other practice location 1

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

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
I20250812003214 MA Practitioner - Nurse Practitioner 8820596455 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Master of Science, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Pediatric Associates, Inc Pediatrics CurrentSince Jun 6, 2025 Accepting new patients
Childrens Hospital Boston Past Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

9 Hope Ave
Waltham, MA 02453
Phone (617) 243-5590

Interoperability endpoints

  • Direct secure messaging: ayegiazaryan30149@direct.bostonchildrens.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1316329402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155737",
            "telephone_number": "617-355-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 HOPE AVE",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024532741",
            "telephone_number": "781-216-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155724",
            "country_code": "US",
            "telephone_number": "617-355-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YEGIAZARYAN",
        "first_name": "ANDREA",
        "middle_name": "GRACE CRISTINA",
        "name_prefix": "Mrs.",
        "credential": "MS, BSN, RN, CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN269529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.