Individual provider Active NPI

Michele Klau

  • Psychiatric/Mental Health Registered Nurse
  • Somerville, MA
National Provider Identifier
1629135090
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
136222 Issued in MA
Practice address
26 Central St
Somerville, MA 02143-2827
Phone
(617) 591-6046
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 136222 MA Primary

Addresses

Primary practice location

26 Central St
Somerville, MA 02143-2827

Mailing address

26 Central St
Somerville, MA 02143-2827

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
I20041201000190 MA Practitioner - Certified Clinical Nurse Specialist (CNS) 8729043724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Trustees of Boston UniversityGroup PAC ID 8921070822, 43 clinicians

Practice addresses (Care Compare)

185 Bay State Rd
Boston, MA 02215-1506
Phone (617) 353-3047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
136222MAMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Boston University CurrentSince Jan 20, 2009 Accepting new patients
Trustees of Boston University CurrentSince Jan 20, 2009 Accepting new patients
Riverside Community Care, Inc. Past Accepting new patients

Locations

185 Bay State Rd
Boston, MA 02215
Phone (617) 353-3047

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629135090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 CENTRAL ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021432827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 CENTRAL ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021432827",
            "telephone_number": "617-591-6046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLAU",
        "first_name": "MICHELE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MA",
            "license": "136222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

Verify at the official NPI Registry.