Individual provider Active NPI

Elena Chapman

  • Family Nurse Practitioner
  • Medford, MA
National Provider Identifier
1679113922
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2275080 Issued in MA
Practice address
293 Salem St 4
Medford, MA 02155
Phone
(978) 760-1012
NPI assigned
Jan 14, 2020
Last updated
Jan 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2275080 MA Primary

Addresses

Primary practice location

293 Salem St 4
Medford, MA 02155

Mailing address

293 Salem St 4
Medford, MA 02155
Phone (978) 760-1012

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
I20200305001461 MA Practitioner - Nurse Practitioner 5193152049 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Perfect Health PCGroup PAC ID 0648496414, 13 clinicians
Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians

Practice addresses (Care Compare)

100 Cambridge St
FL 14
Boston, MA 02114-2509
Phone (888) 553-2823

210 Andover St
Peabody, MA 01960-1647
Phone (978) 488-3234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2275080MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Careathome Medical Practice (Ma), P.C. CurrentSince Feb 12, 2024 Accepting new patients
Perfect Health PC CurrentSince Apr 2, 2021 Accepting new patients
Five Star Medical Office PC Past Accepting new patients

Locations

100 Cambridge St
Fl 14
Boston, MA 02114
Phone (617) 917-2389

75 Arlington St
Ste 500
Boston, MA 02116
Phone (617) 274-8734

169 Madison Ave
Ste 2817
New York, NY 10016
Phone (917) 410-7931

169 Madison Ave
Ste 2829
New York, NY 10016

Interoperability endpoints

  • Direct secure messaging: elena.chapman@allcare.direct.emds.com

Organizations & group practices 4

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": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1679113922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 SALEM ST 4",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "02155",
            "telephone_number": "978-760-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 SALEM ST 4",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "02155",
            "telephone_number": "978-760-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPMAN",
        "first_name": "ELENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "2275080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.