Individual provider Active NPI

Lesli Ellen Warren, CNM

  • Advanced Practice Midwife
  • Brockton, MA
National Provider Identifier
1538327390
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN281104 Issued in MA
Practice address
63 Main St
Brockton, MA 02301-4042
Phone
(508) 559-6699
Fax
(508) 559-5073
NPI assigned
May 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 001533 NY
Advanced Practice Midwife 367A00000X RN281104 MA Primary

Addresses

Primary practice location

63 Main St
Brockton, MA 02301-4042

Mailing address

63 Main St
Brockton, MA 02301-4042
Phone (508) 559-6699

Other identifiers 1

IdentifierTypeStateIssuer
03560267MedicaidNY

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
I20080616000682 MA Practitioner - Certified Nurse Midwife (CNM) 4284705401 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
State University of New York at Stony Brook, School of Medicine, 2007
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)

100 2ND Ave
Needham, MA 02494-2809
Phone (781) 726-4800

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

36 Shops at 5 Way
Plymouth, MA 02360-2677
Phone (774) 608-3700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001533NYMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Nov 1, 2011 Accepting new patients
Harvard Street Neighborhood Health Center Inc CurrentSince Jul 13, 2023 Accepting new patients
Atrius Health, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Atrius Health, Inc. Current Accepting new patients
Atrius Health, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Steward Medical Group, Inc PastSince Nov 1, 2011 Accepting new patients

Locations

147 Milk St
Boston, MA 02109
Phone (617) 421-2508

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

63 Main St
Brockton, MA 02301
Phone (508) 559-6696

632 Blue Hill Ave
Dorchester, MA 02121
Phone (617) 825-3400

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

Interoperability endpoints

  • Direct secure messaging: lwarrencnm382517@direct.atrius.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1538327390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014042",
            "telephone_number": "508-559-6699",
            "fax_number": "508-559-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014042",
            "telephone_number": "508-559-6699",
            "fax_number": "508-559-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "LESLI",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "001533",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MA",
            "license": "RN281104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03560267",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.