Active NPI
Christina M. Defusco, NP
- Adult Health Nurse Practitioner
- Boston, MA
National Provider Identifier
1396067401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- RN202587
- Practice address
- 725 Albany Street
Shapiro 7, Suite B
Boston, MA 02118 - Phone
- (617) 638-8456
- Fax
- (617) 638-8465
- NPI assigned
- Feb 17, 2010
- Last updated
- Jul 16, 2014
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | RN202587 | MA | Primary |
| Critical Care Medicine Nurse Practitioner | 363LC0200X | 202587 | MA |
Addresses
Primary practice location
725 Albany Street
Shapiro 7, Suite B
Boston, MA 02118
Mailing address
720 Harrison Ave
Dob 503
Boston, MA 02118-2371
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110085493A | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN202587 | MA | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405468800000",
"number": "1396067401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 HARRISON AVE",
"address_2": "DOB 503",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 ALBANY STREET",
"address_2": "SHAPIRO 7, SUITE B",
"city": "BOSTON",
"state": "MA",
"postal_code": "02118",
"telephone_number": "617-638-8456",
"fax_number": "617-638-8465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEFUSCO",
"first_name": "CHRISTINA",
"middle_name": "M.",
"name_prefix": "Ms.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-17",
"last_updated": "2014-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MA",
"license": "RN202587",
"primary": true
},
{
"code": "363LC0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Critical Care Medicine",
"state": "MA",
"license": "202587",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110085493A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
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 Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.