Active NPI
Lisa Westcott Vercollone, M.D.
- Internal Medicine Physician
- Boston, MA
National Provider Identifier
1386965028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 269351
- Practice address
- 1153 Centre St
Boston, MA 02130-3446 - Phone
- (617) 983-7000
- NPI assigned
- Jun 17, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD60347934 | WA | |
| Internal Medicine Physician | 207R00000X | 269351 | MA | Primary |
Addresses
Primary practice location
1153 Centre St
Boston, MA 02130-3446
Mailing address
75 Francis St
Boston, MA 02115-6110
Other practice location 1
325 9th Ave
Seattle, WA 98104-2420
Phone (206) 744-3000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386965028 | Medicaid | WA | |
| 314292 | Other | WA | LNI |
Other names 1
- Lisa Espiritu
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 269351 | MA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brigham & Womens Physicians Organization Inc | Internal Medicine | Current | Accepting new patients |
| Brigham and Women'S Faulkner Hospital, Inc. | Past | Accepting new patients |
Locations
15 Francis St
Boston, MA 02115
Phone (617) 732-6770
75 Francis St
Boston, MA 02115
375 Boylston St
Brookline, MA 02445
Phone (508) 718-4010
1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000
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.
-
- Internal Medicine Physician
- Boston, MA
- NPI 1033535497
-
- Psychiatric Hospital Unit
- Boston, MA
- NPI 1033121025
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512432000000",
"number": "1386965028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 FRANCIS ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021156110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1153 CENTRE ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021303446",
"telephone_number": "617-983-7000"
}
],
"practiceLocations": [
{
"address_1": "325 9th Ave",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981042420",
"country_code": "US",
"telephone_number": "206-744-3000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VERCOLLONE",
"first_name": "LISA",
"middle_name": "WESTCOTT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-17",
"last_updated": "2017-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD60347934",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "269351",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1386965028",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LNI",
"identifier": "314292",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LISA",
"last_name": "ESPIRITU",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.