Individual provider Active NPI

Luca Anna Koritsanszky, CNM

  • Advanced Practice Midwife
  • Boston, MA
National Provider Identifier
1417697442
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN2361985 Issued in MA
Practice address
850 Harrison Avenue
FL 4, Yawkey BLDG
Boston, MA 02118
Phone
(617) 414-2000
NPI assigned
Mar 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X RN2361985 MA
Advanced Practice Midwife 367A00000X RN2361985 MA Primary

Addresses

Primary practice location

850 Harrison Avenue
FL 4, Yawkey BLDG
Boston, MA 02118

Mailing address

801 Albany Street
FL G
Boston, MA 02119-3791

Other practice location 1

637 Washington St
Dorchester, MA 02124-3510
Phone (617) 825-9660

Other identifiers 1

IdentifierTypeStateIssuer
110186089AMedicaidMA

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220620000874 MA Practitioner - Certified Nurse Midwife (CNM) 6002295250 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Mattapan Community Health Center, Inc.Group PAC ID 2062423866, 25 clinicians

Practice addresses (Care Compare)

1575 Blue Hill Ave
Boston, MA 02126-2122
Phone (617) 296-0061

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN2361985MAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Mattapan Community Health Center Inc CurrentSince Jul 1, 2024 Accepting new patients
Codman Square Health Center Inc CurrentSince Aug 1, 2022 Accepting new patients
Boston University Obstetrics and Gynecology Foundation, Inc. CurrentSince Jul 11, 2022 Accepting new patients
Mattapan Community Health Center Inc Past Accepting new patients

Locations

850 Harrison Ave
Fl 4
Boston, MA 02118
Phone (617) 414-2000

850 Harrison Ave
#4
Boston, MA 02118
Phone (617) 414-2000

720 Harrison Ave
Ste 1105
Boston, MA 02118
Phone (617) 414-2000

637 Washington St
Dorchestr Ctr, MA 02124
Phone (617) 822-8211

1575 Blue Hill Ave
Mattapan, MA 02126
Phone (617) 296-0061

801 Albany St
Fl G
Roxbury, MA 02119

Interoperability endpoints

  • Direct secure messaging: lkoritsanszky587616@direct.ochin.org
  • Direct secure messaging: lkoritsanszky174964@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": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1417697442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ALBANY STREET",
            "address_2": "FL G",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021193791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVENUE",
            "address_2": "FL 4, YAWKEY BLDG",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-414-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "637 Washington St",
            "address_purpose": "LOCATION",
            "city": "Dorchester",
            "state": "MA",
            "postal_code": "021243510",
            "country_code": "US",
            "telephone_number": "617-825-9660",
            "fax_number": "617-288-7898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORITSANSZKY",
        "first_name": "LUCA",
        "middle_name": "ANNA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "RN2361985",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MA",
            "license": "RN2361985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110186089A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.