Individual provider Active NPI

Heather Denisco, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Belmont, MA
National Provider Identifier
1487121638
Registry record updated Sep 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2309403 Issued in MA
Practice address
115 Mill St
Belmont, MA 02478-1048
Phone
(617) 855-2554
NPI assigned
Oct 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2309403 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2309403 MA Primary

Addresses

Primary practice location

115 Mill St
Belmont, MA 02478-1048

Mailing address

115 Mill St
Belmont, MA 02478-1064
Phone (617) 855-2554

Other practice location 1

25 Staniford St
Boston, MA 02114-2503
Phone (617) 912-7800

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
I20191002000319 MA Practitioner - Nurse Practitioner 1850621046 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2309403MAMDRegistered Nurse
2309403MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The McLean Hospital Corporation CurrentSince Sep 9, 2019 Accepting new patients
The McLean Hospital Corporation Past Accepting new patients

Locations

115 Mill St
Belmont, MA 02478
Phone (617) 855-2000

115 Mill St
Stop 108
Belmont, MA 02478
Phone (202) 412-7369

Organizations & group practices 2

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": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599868800000",
    "number": "1487121638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MILL ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024781064",
            "telephone_number": "617-855-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MILL ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024781048",
            "telephone_number": "617-855-2554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Staniford St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142503",
            "country_code": "US",
            "telephone_number": "617-912-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENISCO",
        "first_name": "HEATHER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-25",
        "last_updated": "2020-09-12",
        "certification_date": "2020-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2309403",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2309403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, MA

Sources for this page

Verify at the official NPI Registry.