Individual provider Active NPI

Kristin Lynn Deangelis, RN, CLC

  • Lactation Consultant (Registered Nurse)
  • Boston, MA
National Provider Identifier
1346048097
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
362564 Issued in MA
Practice address
354 Tremont St
Boston, MA 02116-5538
Phone
(617) 426-9200
Fax
(617) 426-9201
NPI assigned
Mar 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 362564 MA Primary

Addresses

Primary practice location

354 Tremont St
Boston, MA 02116-5538

Mailing address

118 Chandler St
Duxbury, MA 02332-4255
Phone (339) 793-3586

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
362564MAMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Pediatric Associates Inc PastSince Mar 11, 2025 Accepting new patients
Porter Pediatrics Comprehensive Pediatric Health Care.PC PastSince Mar 11, 2025 Accepting new patients

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": "1741219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1346048097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 CHANDLER ST",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "023324255",
            "telephone_number": "339-793-3586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 TREMONT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165538",
            "telephone_number": "617-426-9200",
            "fax_number": "617-426-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANGELIS",
        "first_name": "KRISTIN",
        "middle_name": "LYNN",
        "credential": "RN, CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-06",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MA",
            "license": "362564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.