Individual provider Active NPI

Nairobi Oller-Laureano, CNP

  • Family Medicine Physician
  • East Boston, MA
National Provider Identifier
1356993596
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
RN2291769 Issued in MA
Practice address
10 Gove St
East Boston, MA 02128-1931
Phone
(617) 568-6333
NPI assigned
Jul 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2291769 MA
Family Medicine Physician 207Q00000X RN2291769 MA Primary

Addresses

Primary practice location

10 Gove St
East Boston, MA 02128-1931

Mailing address

10 Gove St
East Boston, MA 02128-1931

Other practice location 1

86 Kirtland St # 2
Lynn, MA 01905-1821
Phone (617) 943-7415

Other names 1

  • Nairobi Oller Former name

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
I20200331001971 MA Practitioner - Nurse Practitioner 7719316470 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2291769MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhealth Corporation CurrentSince Feb 24, 2020 Accepting new patients
Medical Associates of Ebnhc Current Accepting new patients
Internal Medical Associates-Ebnhc CurrentSince Feb 24, 2020 Accepting new patients

Locations

10 Grove St
East Boston, MA 02128
Phone (617) 569-5800

Interoperability endpoints

  • Direct secure messaging: nollerlaureano27790@direct.neighborhealth.masshiway.net

Organizations & group practices 3

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": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1356993596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 GOVE ST",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021281931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 GOVE ST",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021281931",
            "telephone_number": "617-568-6333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "86 Kirtland St # 2",
            "address_purpose": "LOCATION",
            "city": "Lynn",
            "state": "MA",
            "postal_code": "019051821",
            "country_code": "US",
            "telephone_number": "617-943-7415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLLER-LAUREANO",
        "first_name": "NAIROBI",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-09",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "2291769",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "RN2291769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NAIROBI",
            "last_name": "OLLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in East Boston, MA

Sources for this page

Verify at the official NPI Registry.