Individual provider Active NPI

Yelena G Kisel, NP

  • Family Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1619201654
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
252265 Issued in MA
Practice address
100 MLK Jr Blvd
Worcester, MA 01608-1209
Phone
(508) 754-3823
Fax
(508) 753-0151
NPI assigned
Sep 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 252265 MA Primary

Addresses

Primary practice location

100 MLK Jr Blvd
Worcester, MA 01608-1209

Mailing address

100 MLK Jr Blvd
Worcester, MA 01608-1209
Phone (508) 754-3823

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
I20100316000368 MA Practitioner - Nurse Practitioner 8022143098 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Massachusetts Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Worcester Dermatology Associates, P.C.Group PAC ID 4587613369, 4 clinicians
Chelmsford Dermatology PCGroup PAC ID 0840266607, 4 clinicians

Practice addresses (Care Compare)

100 MLK Jr Blvd
Worcester, MA 01608-1209
Phone (508) 754-3823

3 Village SQ
Chelmsford, MA 01824-2712
Phone (978) 256-4151

Merit-based Incentive Payment System (MIPS)

Final score
81.9 of 100Reported as group
Quality
75.39
Improvement activities
40
Cost
72.47

Merit-based Incentive Payment System (MIPS)

Final score
96.71 of 100Reported as individual
Quality
93.42
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
252265MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Worcester Dermatology Associates, P.C. CurrentSince Jan 1, 2010 Accepting new patients
Chelmsford Dermatology, P.C. CurrentSince Aug 23, 2010 Accepting new patients

Locations

3 Village Sq
Chelmsford, MA 01824
Phone (978) 256-4151

100 Mlk Jr Blvd
Ste 4
Worcester, MA 01608
Phone (508) 757-0330

100 Mlk Jr Blvd
Worcester, MA 01608
Phone (508) 754-3823

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253664000000",
    "number": "1619201654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MLK JR BLVD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081209",
            "telephone_number": "508-754-3823",
            "fax_number": "508-753-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MLK JR BLVD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081209",
            "telephone_number": "508-754-3823",
            "fax_number": "508-753-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISEL",
        "first_name": "YELENA",
        "middle_name": "G",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-23",
        "last_updated": "2009-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "252265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.