Individual provider Active NPI

Lauren Elizabeth Fedak, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1326431859
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2292062 Issued in MA
Practice address
780 Albany St
Boston, MA 02118
Phone
(857) 654-1000
NPI assigned
Mar 9, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2292062 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2292062 MA Primary

Addresses

Primary practice location

780 Albany St
Boston, MA 02118

Mailing address

780 Albany St
Boston, MA 02118-2755

Other practice location 1

399 Boylston St
Boston, MA 02116-3305
Phone (617) 213-5077

Other names 1

  • Lauren Elizabeth Donahue 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
I20160315002454 MA Practitioner - Nurse Practitioner 9032415161 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
Group practices

Practice addresses (Care Compare)

112 Southampton St
Boston, MA 02118-2711
Phone (617) 534-2881

17 Court St
Boston, MA 02108-2601
Phone (617) 371-1723

363 Albany St
Boston, MA 02118-2503
Phone (857) 654-1865

39 Boylston St
Boston, MA 02116-4702
Phone (617) 542-4704

444 Harrison Ave
Boston, MA 02118-2404
Phone (857) 654-1850

780 Albany St
Boston, MA 02118-2755
Phone (857) 654-1200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2292062MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Health Care for the Homeless Program, Inc. CurrentSince Feb 13, 2019 Accepting new patients
Boston Health Care for the Homeless Program, Inc. Current Accepting new patients
Boston Health Care for the Homeless Program, Inc. CurrentSince Feb 13, 2019 Accepting new patients

Locations

780 Albany St
#2130
Boston, MA 02118

780 Albany St
Boston, MA 02118
Phone (857) 654-1000

Interoperability endpoints

  • Direct secure messaging: lfedak265182@direct.ochin.org

Organizations & group practices 3

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": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1326431859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "857-654-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "399 Boylston St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021163305",
            "country_code": "US",
            "telephone_number": "617-213-5077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEDAK",
        "first_name": "LAUREN",
        "middle_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-09",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2292062",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2292062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "DONAHUE",
            "middle_name": "ELIZABETH",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.