Individual provider Active NPI

Eugenia Patricia Liacopulos, NP

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1659409928
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
182006 Issued in MA
Practice address
243 Charles St
Mass Eye and Ear Infirmary Medical Unit
Boston, MA 02114-3002
Phone
(617) 573-3720
Fax
(617) 523-0151
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
No

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
Nurse Practitioner 363L00000X 182006 MA Primary

Addresses

Primary practice location

243 Charles St
Mass Eye and Ear Infirmary Medical Unit
Boston, MA 02114-3002

Mailing address

Mass Eye and Ear Infirmary Medical Unit
243 Charles Street
Boston, MA 02114
Phone (617) 573-3720

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
I20050928001263 MA Practitioner - Nurse Practitioner 9335174366 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
182006MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince May 28, 2017 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Feb 1, 2021 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince May 28, 2017 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Feb 1, 2021 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince May 28, 2017 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince May 28, 2017 Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

Interoperability endpoints

  • Direct secure messaging: liacopulos.eugenia.bwh@direct.partners.masshiway.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Holy Trinity Nursing & RehabWorcester, MA, CCN 225648 Skilled nursing facility Managing Control - Governing Body
Trustee of the SNF
Indirect Ownership Interest
Oct 1, 2021
Oct 1, 2021
Oct 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659409928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MASS EYE AND EAR INFIRMARY MEDICAL UNIT",
            "address_2": "243 CHARLES STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-573-3720",
            "fax_number": "617-523-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "address_2": "MASS EYE AND EAR INFIRMARY MEDICAL UNIT",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143002",
            "telephone_number": "617-573-3720",
            "fax_number": "617-523-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIACOPULOS",
        "first_name": "EUGENIA",
        "middle_name": "PATRICIA",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "182006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.