NPIMap

Individual provider Active NPI

Kaitlyn N Sanders, RN, MSN

  • Women's Health Nurse Practitioner
  • Roxbury, MA
National Provider Identifier
1598426421
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
RN2338208 Issued in MA
Practice address
45 Dimock St
Roxbury, MA 02119-1208
Phone
(617) 442-8800
Fax
(617) 541-8472
NPI assigned
Jan 3, 2022
Last updated
Mar 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2338208 MA
Primary Care Nurse Practitioner 363LP2300X RN2338208 MA
Women's Health Nurse Practitioner 363LW0102X RN2338208 MA Primary

Addresses

Primary practice location

45 Dimock St
Roxbury, MA 02119-1208

Mailing address

42 Olney St Apt 3F
Dorchester, MA 02121-3529
Phone (717) 368-4318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220428000593 MA Practitioner - Nurse Practitioner 8224425954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Internal Medical Associates-EbnhcGroup PAC ID 6103814371, 239 clinicians

Practice addresses (Care Compare)

10 Gove St
East Boston, MA 02128-1920
Phone (617) 569-5800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN2338208MAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Ebnhc Current Accepting new patients
Internal Medical Associates-Ebnhc CurrentSince Aug 19, 2024 Accepting new patients
Neighborhealth Corporation Past Accepting new patients

Locations

10 Grove St
East Boston, MA 02128
Phone (617) 569-5800

Interoperability endpoints

  • Direct secure messaging: ksanders43308@direct.neighborhealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1598426421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 OLNEY ST APT 3F",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021213529",
            "telephone_number": "717-368-4318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 DIMOCK ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191208",
            "telephone_number": "617-442-8800",
            "fax_number": "617-541-8472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "KAITLYN",
        "middle_name": "N",
        "credential": "RN, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-03",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2338208",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "RN2338208",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "RN2338208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

Verify at the official NPI Registry.