Individual provider Active NPI

Susan Bove, NP

  • Family Nurse Practitioner
  • Stoneham, MA
National Provider Identifier
1497719124
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
182071 Issued in MA
Practice address
88 Monvale Ave
Stoneham, MA 02180
Phone
(781) 662-6400
Fax
(781) 662-2965
NPI assigned
Apr 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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 182071 MA
Family Nurse Practitioner 363LF0000X 182071 MA Primary

Addresses

Primary practice location

88 Monvale Ave
Stoneham, MA 02180

Mailing address

88 Monvale Ave
Stoneham, MA 02180
Phone (781) 662-6400

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
I20060118000671 MA Practitioner - Nurse Practitioner 2466476353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

2 Essex Ctr Dr
Peabody, MA 01960-2902
Phone (978) 977-4000

Hospital & facility affiliations

  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033
  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
182071MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. CurrentSince Oct 1, 2021 Accepting new patients
Atrius Health, Inc. CurrentSince Oct 1, 2021 Accepting new patients
Winchester Physician Associates Past Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

2 Essex Dr
Peabody, MA 01960
Phone (978) 532-6111

Interoperability endpoints

  • Direct secure messaging: sbovenp338739@direct.atrius.masshiway.net

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1497719124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 MONVALE AVE",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "02180",
            "telephone_number": "781-662-6400",
            "fax_number": "781-662-2965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 MONVALE AVE",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "02180",
            "telephone_number": "781-662-6400",
            "fax_number": "781-662-2965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVE",
        "first_name": "SUSAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "182071",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "182071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoneham, MA

Sources for this page

Verify at the official NPI Registry.