Individual provider Active NPI

Deborah Deangelis

  • Adult Health Nurse Practitioner
  • Lawrence, MA
National Provider Identifier
1669882593
Registry record updated Mar 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2284879 Issued in MA
Practice address
34 Haverhill St
Lawrence, MA 01841-2884
Phone
(978) 686-3017
Fax
(978) 685-4280
NPI assigned
Apr 30, 2014
Last updated
Mar 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2284879 MA Primary
Registered Nurse 163W00000X RN2284879 MA

Addresses

Primary practice location

34 Haverhill St
Lawrence, MA 01841-2884

Mailing address

34 Haverhill St
Lawrence, MA 01841-2884
Phone (978) 686-3017

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
I20150416000662 MA Practitioner - Nurse Practitioner 9133447477 Reassigns benefits to 1 organization

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

Practice addresses (Care Compare)

73 D Winthrop Ave
Plaza 114
Lawrence, MA 01843-3716
Phone (978) 686-3017

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2284879MAMDRegistered Nurse
2284879MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Lawrence Family Health Center Inc CurrentSince Feb 2, 2015 Accepting new patients
Greater Lawrence Family Health Center, Inc. CurrentSince Feb 2, 2015 Accepting new patients

Locations

150 Park St
Lawrence, MA 01841
Phone (978) 685-1770

34 Haverhill St
Lawrence, MA 01841

73D Winthrop Ave
#114
Lawrence, MA 01843
Phone (978) 686-3017

Interoperability endpoints

  • Direct secure messaging: deborah.deangelis.1@23857.direct.athenahealth.com

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.

Hospital & facility affiliations 1

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": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425600000000",
    "number": "1669882593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 HAVERHILL ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412884",
            "telephone_number": "978-686-3017",
            "fax_number": "978-685-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 HAVERHILL ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412884",
            "telephone_number": "978-686-3017",
            "fax_number": "978-685-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANGELIS",
        "first_name": "DEBORAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-30",
        "last_updated": "2015-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "2284879",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2284879",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.