Individual provider Active NPI

Colleen Marie Danielson, N.P.

  • Family Nurse Practitioner
  • Boston, MA
National Provider Identifier
1629355136
Registry record updated Nov 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN280062 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(857) 238-5900
NPI assigned
Nov 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2011

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 RN280062 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

10 Faxon Ave
Apt 607
Quincy, MA 02169-4682
Phone (617) 851-0855

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
I20121016000505 MA Practitioner - Nurse Practitioner 7416107099 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The General Hospital CorporationGroup PAC ID 6507803806, 1,275 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-2000

Hospital & facility affiliations

  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Massachusetts Eye and Ear Infirmary - Hospital, Boston, MA, CCN 220075

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN280062MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc CurrentSince Jul 1, 2012 Accepting new patients
General Hospital Corp Current Accepting new patients
The General Hospital Corporation CurrentSince Jul 1, 2016 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Interoperability endpoints

  • Direct secure messaging: danielson.colleen.mgh@direct.partners.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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1320969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320969600000",
    "number": "1629355136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 FAXON AVE",
            "address_2": "APT 607",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694682",
            "telephone_number": "617-851-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "857-238-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELSON",
        "first_name": "COLLEEN",
        "middle_name": "MARIE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-11",
        "last_updated": "2011-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN280062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.