Individual provider Active NPI

Mackie K. Alexis, NP

  • Chore Provider
  • West Roxbury, MA
National Provider Identifier
1528330701
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Chore ProviderTaxonomy code 372500000X
License
251788 Issued in MA
Practice address
29 Gould St
West Roxbury, MA 02132-5024
Phone
(617) 596-7201
NPI assigned
Feb 2, 2012
Last updated
Jan 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN251788 MA
Chore Provider 372500000X 251788 MA Primary

Addresses

Primary practice location

29 Gould St
West Roxbury, MA 02132-5024

Mailing address

29 Gould St
West Roxbury, MA 02132-5024
Phone (617) 596-7201

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
I20180329000389 MA Practitioner - Nurse Practitioner 1759643877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

1269 Beacon St
Suite 2
Brookline, MA 02446-5248
Phone (855) 284-7483

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN251788MAMDFamily Nurse Practitioner
251788MAMDChore Provider

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Nov 18, 2022 Accepting new patients
Salus Mental Health Care LLC Current Accepting new patients

Locations

1269 Beacon St
Ste 2
Brookline, MA 02446
Phone (617) 934-1974

872 Massachusetts Ave
Ste 2-2
Cambridge, MA 02139
Phone 6173804651 ext. 1992

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, 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": "1328140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1528330701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 GOULD ST",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021325024",
            "telephone_number": "617-596-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 GOULD ST",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021325024",
            "telephone_number": "617-596-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXIS",
        "first_name": "MACKIE",
        "middle_name": "K.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-02",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN251788",
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "MA",
            "license": "251788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Roxbury, MA

Sources for this page

Verify at the official NPI Registry.