Individual provider Active NPI

Elenora Smith Watson, CNP

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1558843474
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2268637 Issued in MA
Practice address
330 Brookline Ave
Boston, MA 02215-5491
Phone
(617) 667-7000
NPI assigned
Sep 6, 2018
Last updated
Apr 3, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2268637 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Boston, MA 02215-5491

Mailing address

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 667-1062

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
I20190110000433 MA Practitioner - Nurse Practitioner 7618213786 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 754-8612

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Dec 1, 2018 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Dec 1, 2018 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Nov 21, 2018 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Nov 21, 2018 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

330 Brookline Ave
#407
Boston, MA 02215
Phone (617) 667-5048

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1558843474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-1062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155491",
            "telephone_number": "617-667-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ELENORA",
        "middle_name": "SMITH",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-06",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2268637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.