Individual provider Active NPI

Irina Seliverstov, N.P.

  • Nurse Practitioner
  • Lynn, MA
National Provider Identifier
1386646099
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
218125 Issued in MD
Practice address
34 State St
Lynn, MA 01901-1505
Phone
(781) 581-6181
Fax
(781) 599-3229
NPI assigned
Aug 12, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 218125 MD Primary

Addresses

Primary practice location

34 State St
Lynn, MA 01901-1505

Mailing address

34 State St
Lynn, MA 01901-1505
Phone (781) 581-6181

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
I20060130000274 MA Practitioner - Nurse Practitioner 5092729095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alexeyenko Medical Associates PCGroup PAC ID 0042253643, 3 clinicians

Practice addresses (Care Compare)

24 State St
Lynn, MA 01901-1505
Phone (781) 581-6181

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
218125MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alexeyenko Medical Associates Current Accepting new patients
Alexeyenko Medical Associates PC CurrentSince Apr 20, 2000 Accepting new patients

Locations

34 State St
Lynn, MA 01901
Phone (781) 581-6181

34 State St
#A
Lynn, MA 01901
Phone (781) 581-6181

24 State St
Lynn, MA 01901
Phone (781) 581-6181

Interoperability endpoints

  • Direct secure messaging: seliverstov.irina.ama@direct.partners.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.

Hospital & facility affiliations 4

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1386646099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 STATE ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011505",
            "telephone_number": "781-581-6181",
            "fax_number": "781-599-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 STATE ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011505",
            "telephone_number": "781-581-6181",
            "fax_number": "781-599-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELIVERSTOV",
        "first_name": "IRINA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "218125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.