NPIMap

Organization Active NPI

Northeast Professional Registry of Nurses Inc

Doing business as Beth Israel Lahey Health at Home

  • Home Health Agency
  • Woburn, MA
National Provider Identifier
1346257474
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
T6IL Issued in MA
Legal business name
NORTHEAST PROFESSIONAL REGISTRY OF NURSES INC
Doing business as
Beth Israel Lahey Health at Home
DBA Lahey Health at Home
Practice address
800 W Cummings Park Ste 5000
Woburn, MA 01801-6356
Phone
(781) 756-2488
Fax
(781) 756-2654
NPI assigned
Aug 2, 2006
Last updated
Oct 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Authorized official

Name
Deborah Costello, RN
Title
Chief Operating Officer
Phone
(978) 712-1233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X T6IL MA Primary

Addresses

Primary practice location

800 W Cummings Park Ste 5000
Woburn, MA 01801-6356

Mailing address

800 W Cummings Park Ste 5000
Woburn, MA 01801-6356
Phone (781) 756-2488

Other identifiers 1

IdentifierTypeStateIssuer
0608513MedicaidMA

Other names 2

  • Beth Israel Lahey Health at Home Doing business as
  • DBA Lahey Health at Home Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060501000294 MA Part A Provider - Home Health Agency 0840200267 Practice locations: Cambridge, MA; Danvers, MA; Woburn, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346257474. Details of each certification follow.

Home health agency certification: CCN 227495

Legal name
NORTHEAST PROFESSIONAL REGISTRY OF NURSES, INC.
Doing business as
BETH ISRAEL LAHEY HEALTH AT HOME
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 5, 2006
Last certification
Dec 5, 2019
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Dec 5, 2006 in MA
Enrollment address
199 Rosewood Dr
Ste 380
Danvers, MA 01923-4516
HHA Branch

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Beth Israel Lahey Health at HomeCCN 227495 · All quality measures
Overall star rating
3 of 5
Ownership
Non-Profit
Certified
Dec 5, 2006
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D1059479Northeast Professional Registry of Nurses Inc199 Rosewood Dr, Danvers, MA 01923Certificate of waiverMar 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Northeast Professional Registry of Nurses Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Beth Israel Lahey Health, Inc. Organization, Boston, MA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2019 100%
Jennifer Gizmunt Individual Corporate OfficerPresident Apr 1, 2018 100%
Leslie a Joseph Individual Corporate OfficerAssistant Deputy General Counsel Dec 18, 2020 20%
Lahey Health System Inc Organization, Burlington, MA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest May 1, 2012 100%
Deborah a Costello Individual Corporate DirectorChief Operating Officer Mar 4, 2013 90%
W-2 Managing EmployeeChief Operating Officer Mar 14, 2013 80%
North East Senior Health Corporation Organization, Beverly, MA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Mar 8, 2012 100%
Karen Eichhorn Individual Corporate OfficerChief Financial Officer Dec 18, 2020 80%
W-2 Managing EmployeeChief Financial Officer Dec 18, 2020 80%

Facilities with the same owner 18

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 18

Practitioners & affiliated clinicians

Affiliated clinicians 446

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 446

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1346257474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W CUMMINGS PARK STE 5000",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016356",
            "telephone_number": "781-756-2488",
            "fax_number": "781-756-2654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W CUMMINGS PARK STE 5000",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016356",
            "telephone_number": "781-756-2488",
            "fax_number": "781-756-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST PROFESSIONAL REGISTRY OF NURSES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "978-712-1233",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MA",
            "license": "T6IL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0608513",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beth Israel Lahey Health at Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DBA Lahey Health at Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woburn, MA

Sources for this page

Verify at the official NPI Registry.