Active NPI
Kathryn Delack, NP
- Neonatal Nurse Practitioner
- Boston, MA
National Provider Identifier
1407159247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- NPP37591
- Practice address
- 55 Fruit St
Boston, MA 02114-2621 - Phone
- (617) 726-2000
- NPI assigned
- Dec 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 |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | NPP37591 | RI | Primary |
| Nurse Practitioner | 363L00000X | RN273564 | MA |
Addresses
Primary practice location
55 Fruit St
Boston, MA 02114-2621
Mailing address
18 Riverwood Dr
Mansfield, MA 02048-1775
Phone (617) 212-5318
Other names 1
- Kathryn O'Brien
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
- Certified Nurse Practitioner, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| General Hospital Corp | Current | Accepting new patients |
Locations
55 Fruit St
Boston, MA 02114
55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967
Interoperability endpoints
- delack.kathryn.mgh@direct.partners.masshiway.net
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Boston, MA
- NPI 1508390014
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493251200000",
"number": "1407159247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 RIVERWOOD DR",
"city": "MANSFIELD",
"state": "MA",
"postal_code": "020481775",
"telephone_number": "617-212-5318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142621",
"telephone_number": "617-726-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELACK",
"first_name": "KATHRYN",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-17",
"last_updated": "2017-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "RI",
"license": "NPP37591",
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "RN273564",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATHRYN",
"last_name": "O'BRIEN",
"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 Apr 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.