Individual provider Active NPI

Lauren Rose Botelho, MSN, FNP-BC, RD, LDN

  • Family Nurse Practitioner
  • Southborough, MA
National Provider Identifier
1346600475
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2349852 Issued in MA
Practice address
24 Newton St
Southborough, MA 01772-1215
Phone
(508) 460-3258
NPI assigned
Mar 2, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 4074 MA
Family Nurse Practitioner 363LF0000X RN2349852 MA Primary

Addresses

Primary practice location

24 Newton St
Southborough, MA 01772-1215

Mailing address

24 Newton St
Southborough, MA 01772-1215

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
I20230228000295 MA Practitioner - Nurse Practitioner 8921471699 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4074MAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Rehab Consultants PLLC Family CurrentSince Jan 21, 2024 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

40 Parkhurst Rd
Chelmsford, MA 01824
Phone (978) 251-3151

184 Main St
Fairhaven, MA 02719
Phone (508) 742-3737

121 Northboro Rd E
Marlborough, MA 01752
Phone (508) 485-4040

Interoperability endpoints

  • Direct secure messaging: lauren.botelho.npi1346600475.reliant@direct.optumcare.masshiway.net

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": "1456876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1346600475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 NEWTON ST",
            "city": "SOUTHBOROUGH",
            "state": "MA",
            "postal_code": "017721215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 NEWTON ST",
            "city": "SOUTHBOROUGH",
            "state": "MA",
            "postal_code": "017721215",
            "telephone_number": "508-460-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTELHO",
        "first_name": "LAUREN",
        "middle_name": "ROSE",
        "credential": "MSN, FNP-BC, RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-02",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "4074",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2349852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southborough, MA

Sources for this page

Verify at the official NPI Registry.