Mary E Boratyn, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

NPP37490 Issued in RI

Practice address

186 Providence St
Thundermist Health Center
West Warwick, RI 02893-2508

Phone

(401) 615-2800

Fax

(401) 615-2805

NPI assigned

Nov 11, 2008

Last updated

Jan 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• East Side Pediatrics PC

  • Pediatrics Physician
  • Rumford, RI
  • NPI 1285815993
  NPD

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

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1649424169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 GOVERNOR ST STE 3",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029063237",
            "telephone_number": "401-383-4411",
            "fax_number": "401-383-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 PROVIDENCE ST",
            "address_2": "THUNDERMIST HEALTH CENTER",
            "city": "WEST WARWICK",
            "state": "RI",
            "postal_code": "028932508",
            "telephone_number": "401-615-2800",
            "fax_number": "401-615-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORATYN",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-11",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "RI",
            "license": "NPP37490",
            "primary": true
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "RI",
            "license": "NPP37490",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MA73809",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ann Marie Bissonnette, PT OCS
• Beth Ann Bixby, LICSW
• Michelle Blade Mello, CNM, FNP
• Blossom Health LLC
• Anne Marie Bood, LICSW
• Jaimie Borden, PMHNP
• Claudia Botthof, LMT
• Thomas Botthof, LMT
• Helene Marie Bradley, O.D.
• Gretchen Lee Breen, OTD

• Pediatric Nurse Practitioner in West Warwick, RI
• Providers in West Warwick, RI by specialty
• Pediatric Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; 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.