Individual provider Active NPI

Mandi L Boisvert, FNP-C

  • Family Nurse Practitioner
  • Hartford, CT
National Provider Identifier
1356790752
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6546 Issued in CT
Practice address
282 Washington Street
Hartford, CT 06106
Phone
(860) 545-9200
Fax
(860) 545-9134
NPI assigned
Jun 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 6546 CT Primary

Addresses

Primary practice location

282 Washington Street
Hartford, CT 06106

Mailing address

188 Imperial Drive
Glastonbury, CT 06033
Phone (860) 986-4739

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mboisvert8116@direct.connecticutchildrens.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20161018000862 CT Practitioner - Nurse Practitioner 1850689290 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6546CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Children'S Specialty Group, Inc. CurrentSince Oct 1, 2016 Accepting new patients
Connecticut Children'S Specialty Group, Inc. CurrentSince Oct 1, 2016 Accepting new patients

Locations

60 Hartland St
East Hartford, CT 06108

599 Farmington Ave
Ste 202
Farmington, CT 06032
Phone (860) 837-5170

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

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": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1356790752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 IMPERIAL DRIVE",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "06033",
            "telephone_number": "860-986-4739",
            "fax_number": "860-430-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 WASHINGTON STREET",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06106",
            "telephone_number": "860-545-9200",
            "fax_number": "860-545-9134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOISVERT",
        "first_name": "MANDI",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "6546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mboisvert8116@direct.connecticutchildrens.org",
            "affiliation": "N",
            "address_1": "282 Washington Street",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "06106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.