Individual provider Active NPI

Laurie B. Botie, MD

  • Family Medicine Physician
  • Tewksbury, MA
National Provider Identifier
1639293558
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
46137 Issued in MA
Practice address
600 Clark Rd
Tewksbury, MA 01876-1699
Phone
(978) 453-9272
Fax
(978) 970-1506
NPI assigned
Mar 17, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 46137 MA Primary

Addresses

Primary practice location

600 Clark Rd
Tewksbury, MA 01876-1699

Mailing address

600 Clark Rd
Tewksbury, MA 01876-1699
Phone (978) 453-9272

Other identifiers 8

IdentifierTypeStateIssuer
6727439OtherMACIGNA HEALTHCARE
B46048OtherMABL CRS BL SHLD INDIV #
701208OtherMATUFTS
7662OtherMAHARVARD PILGRIM
92117OtherMAAETNA INDIVIDUAL #
01-00704OtherMAUNITED HEALTHCARE
30002667OtherNHMEDICAID NEW HAMPSHIRE
0154008MedicaidMA

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
I20051107000731 MA Practitioner - Family Practice 7416975552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Addiction Medicine
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

214 Howard St
Framingham, MA 01702-8311

National Provider Directory

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1639293558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CLARK RD",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018761699",
            "telephone_number": "978-453-9272",
            "fax_number": "978-970-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CLARK RD",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018761699",
            "telephone_number": "978-453-9272",
            "fax_number": "978-970-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTIE",
        "first_name": "LAURIE",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "46137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "6727439",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BL CRS BL SHLD INDIV #",
            "identifier": "B46048",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "701208",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "7662",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INDIVIDUAL #",
            "identifier": "92117",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "01-00704",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID NEW HAMPSHIRE",
            "identifier": "30002667",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0154008",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tewksbury, MA

Sources for this page

Verify at the official NPI Registry.