Individual provider Active NPI

Elizabeth Patricia Woodard, RN, MSN, CPNP-AC/PC

  • Pediatric Nurse Practitioner
  • Boston, MA
National Provider Identifier
1417500935
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN2272255 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2696
Phone
(617) 726-2000
NPI assigned
Jul 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2272255 MA
Pediatric Nurse Practitioner 363LP0200X RN2272255 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2696

Mailing address

960 Massachusetts Ave
FL 2
Boston, MA 02118-2690

Other practice location 1

736 Cambridge St
Brighton, MA 02135-2907
Phone (617) 562-7077

Other names 1

  • Elizabeth Patricia Daley Former name

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
I20191104000896 MA Practitioner - Nurse Practitioner 2860724374 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN2272255MAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc CurrentSince Feb 11, 2021 Accepting new patients
The General Hospital Corporation CurrentSince Feb 11, 2021 Accepting new patients
Steward Medical Group, Inc CurrentSince Dec 4, 2023 Accepting new patients
BMC Affiliated Physicians, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Steward Medical Group, Inc CurrentSince Dec 4, 2023 Accepting new patients

Locations

960 Massachusetts Ave
Ste 2
Boston, MA 02118

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
Boston, MA 02114

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

70 East St
Methuen, MA 01844
Phone (978) 682-1906

1 Boston Medical Ctr Pl
Roxbury, MA 02118
Phone (617) 414-5245

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

Interoperability endpoints

  • Direct secure messaging: ewoodard120590@direct.bmc.masshiway.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1417500935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-726-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "736 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021352907",
            "country_code": "US",
            "telephone_number": "617-562-7077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "ELIZABETH",
        "middle_name": "PATRICIA",
        "credential": "RN, MSN, CPNP-AC/PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2272255",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2272255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "DALEY",
            "middle_name": "PATRICIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.