Individual provider Active NPI

Nicole Ann O'Brien, NP

  • Pediatric Nurse Practitioner
  • Stoneham, MA
National Provider Identifier
1639887060
Registry record updated May 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN2327337 Issued in MA
Practice address
92 Montvale Ave
Stoneham, MA 02180-3647
Phone
(781) 451-0072
NPI assigned
Nov 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X RN2327337 MA
Pediatric Nurse Practitioner 363LP0200X RN2327337 MA Primary

Addresses

Primary practice location

92 Montvale Ave
Stoneham, MA 02180-3647

Mailing address

13 Greenmeadow Dr
N Billerica, MA 01862-1921
Phone (781) 439-0389

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2327337MAMDPediatric Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Pediatrics, LLC Past Accepting new patients

Organizations & group practices 1

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": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780185600000",
    "number": "1639887060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 GREENMEADOW DR",
            "city": "N BILLERICA",
            "state": "MA",
            "postal_code": "018621921",
            "telephone_number": "781-439-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 MONTVALE AVE",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803647",
            "telephone_number": "781-451-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-15",
        "last_updated": "2026-05-31",
        "certification_date": "2026-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MA",
            "license": "RN2327337",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2327337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoneham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.