Individual provider Active NPI

Kerry Nussbaum, NP

  • Family Nurse Practitioner
  • South Weymouth, MA
National Provider Identifier
1376365833
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN256426 Issued in MA
Practice address
541 Main St Ste 301
South Weymouth, MA 02190-1889
Phone
(781) 952-1480
NPI assigned
Oct 28, 2024
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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 RN256426 MA Primary

Addresses

Primary practice location

541 Main St Ste 301
South Weymouth, MA 02190-1889

Mailing address

541 Main St Ste 301
South Weymouth, MA 02190-1889
Phone (781) 952-1480

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
I20241212003521 MA Practitioner - Nurse Practitioner 9931635042 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harbor Medical Associates IncGroup PAC ID 2466356209, 130 clinicians

Practice addresses (Care Compare)

2014 Washington St
Newton, MA 02462-1607
Phone (617) 243-6000

541 Main St
Suite 301
S Weymouth, MA 02190-1889
Phone (781) 952-1480

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Medical Associates, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Mass General Brigham Medical Group Suburban Massachusetts Inc CurrentSince Jan 1, 2026 Accepting new patients
Harbor Medical Associates, Inc. CurrentSince Dec 1, 2024 Accepting new patients

Locations

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

541 Main St
Ste 301
South Weymouth, MA 02190
Phone (781) 952-1480

541 Main St
Ste 314
Weymouth, MA 02190
Phone (781) 952-1200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1376365833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 MAIN ST STE 301",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021901889",
            "telephone_number": "781-952-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 MAIN ST STE 301",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021901889",
            "telephone_number": "781-952-1480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSSBAUM",
        "first_name": "KERRY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN256426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Weymouth, MA

Sources for this page

Verify at the official NPI Registry.