Individual provider Active NPI

Nicole Anna Louis-Jean, DO

  • Family Medicine Physician
  • Ipswich, MA
National Provider Identifier
1619473733
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
295367 Issued in MA
Practice address
36 Essex Rd Ste 1
Ipswich, MA 01938-2609
Phone
(978) 356-5522
Fax
(978) 356-0218
NPI assigned
Apr 5, 2018
Last updated
Nov 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 311861 NY
Family Medicine Physician 207Q00000X 295367 MA Primary

Addresses

Primary practice location

36 Essex Rd Ste 1
Ipswich, MA 01938-2609

Mailing address

PO Box 24532
New York, NY 10087-4532
Phone (781) 744-8771

Other practice location 1

41 Mall Rd
Burlington, MA 01805-2618
Phone (781) 744-8000

Other practice location 2

13303 Jamaica Ave
Jamaica, NY 11418-2618
Phone (718) 206-6942

Other names 1

  • Nicole Butuzov Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230125001482 MA Practitioner - Family Practice 8325383557 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, 1,381 clinicians

Practice addresses (Care Compare)

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

29 Mall Rd
Burlington, MA 01805-0001

298 Washington St
Addison Gilbert
Gloucester, MA 01930-4832
Phone (978) 283-4000

36 Essex Rd
Ipswich, MA 01938-2599
Phone (978) 356-5522

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8771

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Primary Care, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Lahey Clinic, Inc CurrentSince Dec 1, 2022 Accepting new patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Sep 1, 2025 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. Past Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

36 Essex Rd
Ste 1
Ipswich, MA 01938
Phone (978) 356-5522

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.laheyhealth.org/proxy-prd-fhir/api/FHIR/R4/
  • Direct secure messaging: nbutuzov192312@direct.bilh.masshiway.net

Organizations & group practices 4

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 6

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": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1619473733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24532",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100874532",
            "telephone_number": "781-744-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 ESSEX RD STE 1",
            "city": "IPSWICH",
            "state": "MA",
            "postal_code": "019382609",
            "telephone_number": "978-356-5522",
            "fax_number": "978-356-0218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018052618",
            "country_code": "US",
            "telephone_number": "781-744-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13303 Jamaica Ave",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114182618",
            "country_code": "US",
            "telephone_number": "718-206-6942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOUIS-JEAN",
        "first_name": "NICOLE",
        "middle_name": "ANNA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "311861",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "295367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "BUTUZOV",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ipswich, MA

Sources for this page

Verify at the official NPI Registry.