Individual provider Active NPI

Tina Ann Flaherty, N.P.

  • Acute Care Nurse Practitioner
  • Boston, MA
National Provider Identifier
1437366101
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
191108 Issued in MA
Practice address
450 Brookline Ave # D1B30
Boston, MA 02215-5418
Phone
(617) 632-5082
Fax
(617) 582-8608
NPI assigned
May 16, 2007
Last updated
Jun 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 191108 MA Primary

Addresses

Primary practice location

450 Brookline Ave # D1B30
Boston, MA 02215-5418

Mailing address

450 Brookline Ave
D1B30
Boston, MA 02115-6013
Phone (617) 632-5082

Other names 1

  • Mrs. Tina Ann Pellegrino-Flaherty 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
I20080905000302 MA Practitioner - Nurse Practitioner 2567538184 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
191108MAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Medical Group, Inc Current Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Sep 6, 2016 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Sep 6, 2016 Accepting new patients
Pratt Medical Group, Inc CurrentSince Sep 13, 2024 Accepting new patients
Pratt Medical Group, Inc CurrentSince Sep 13, 2024 Accepting new patients
Pratt Medical Group, Inc Past Accepting new patients

Locations

44 Binney St
#D1B30
Boston, MA 02115
Phone (617) 582-8487

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

450 Brookline Ave
#1B
Boston, MA 02215
Phone (617) 582-8448

450 Brookline Ave
#1B15
Boston, MA 02215
Phone (617) 632-5082

450 Brookline Ave
#D1B30
Boston, MA 02215
Phone (617) 582-8431

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

Interoperability endpoints

  • Direct secure messaging: flaherty.tina.dfci@direct.partners.masshiway.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1437366101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 BROOKLINE AVE",
            "address_2": "D1B30",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156013",
            "telephone_number": "617-632-5082",
            "fax_number": "617-582-8608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BROOKLINE AVE # D1B30",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155418",
            "telephone_number": "617-632-5082",
            "fax_number": "617-582-8608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAHERTY",
        "first_name": "TINA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "191108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "PELLEGRINO-FLAHERTY",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.