Kellie St Martin

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2295376 Issued in MA

Practice address

415 Columbia Rd
Boston, MA 02125-2424

Phone

(617) 287-8000

Fax

(617) 287-1500

NPI assigned

Jan 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kellie St Martin Professional name

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Uphams Corner Health Committee IncGroup PAC ID 4284645086, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boston Medical Center Hospital, Boston, MA, CCN 220031

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kstmartin332664@direct.ochin.org

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.

• Upham'S Corner Health Committee, Inc.

  • Community Health Clinic/Center
  • Dorchester, MA
  • NPI 1780780486
  Medicare reassignment Care Compare group NPD
• Pathways Healthcare, LLC

  • Home Health Agency
  • Westwood, MA
  • NPI 1740529668
  Medicare reassignment
• Kingsbury Primary Care PC

  • Internal Medicine Physician
  • Kingston, MA
  • NPI 1902103385
  NPD (past)

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

• Boston Medical Center

  • Clinic/Center
  • Dorchester, MA
  • NPI 1487844726

  Hospital

  Care Compare affiliation
• Boston Medical Center Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1164177028
  Care Compare affiliation
• Boston Medical Center Corporation

  • Community Health Clinic/Center
  • South Boston, MA
  • NPI 1225228679

  Hospital

  Care Compare affiliation
• Boston Medical Center Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1346218294
  Care Compare affiliation
• Boston Medical Center Corporation

  • Community Health Clinic/Center
  • Roslindale, MA
  • NPI 1386718823

  Hospital

  Care Compare affiliation
• Boston Medical Center Corporation

  • Community Health Clinic/Center
  • Dorchester, MA
  • NPI 1780874677

  Hospital

  Care Compare affiliation
• Boston Medical Center Corporation

  • Community Health Clinic/Center
  • East Boston, MA
  • NPI 1861683518

  Hospital

  Care Compare affiliation
• Medical Associates of Ebnhc

  • Community Health Clinic/Center
  • East Boston, MA
  • NPI 1255451597

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1598305807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 COLUMBIA RD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021252424",
            "telephone_number": "617-287-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 COLUMBIA RD",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021252424",
            "telephone_number": "617-287-8000",
            "fax_number": "617-287-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST MARTIN",
        "first_name": "KELLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2023-06-27",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "2295376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "ST MARTIN",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Maria St Germain
• Andrea St Jean
• Mary St John
• Katherine E St Lawrence, LICSW
• Marcelle St Louis, RN
• Mahala St Paul, NP
• Steven Lynn St Peter, MD
• Nadja St-Surin, FNP
• Othniel St-Ulme
• St. Anthony Shrine

• Adult Health Nurse Practitioner in Boston, MA
• Providers in Boston, MA by specialty
• Adult Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.