Individual provider Active NPI

Sara Trudel, NP

  • Pediatric Nurse Practitioner
  • Lynn, MA
National Provider Identifier
1356747000
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN2271620 Issued in MA
Practice address
269 Union St
Lynn, MA 01901-1314
Phone
(781) 581-3900
NPI assigned
Nov 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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 RN2271620 MA Primary

Addresses

Primary practice location

269 Union St
Lynn, MA 01901-1314

Mailing address

269 Union St
Lynn, MA 01901-1314
Phone (781) 581-3900

Other practice location 1

298 Washington St
Gloucester, MA 01930-4832
Phone (978) 283-5079

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
I20180202000407 MA Order and Referring Only - Nurse Practitioner 5991065369

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: strudel224732@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1415318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1356747000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 UNION ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011314",
            "telephone_number": "781-581-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 UNION ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011314",
            "telephone_number": "781-581-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "298 Washington St",
            "address_purpose": "LOCATION",
            "city": "Gloucester",
            "state": "MA",
            "postal_code": "019304832",
            "country_code": "US",
            "telephone_number": "978-283-5079",
            "fax_number": "978-282-1371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUDEL",
        "first_name": "SARA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-07",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2271620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.