Kristy Poulliot, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN2268086 Issued in MA

Practice address

29 Hudson Rd Ste 3310
Sudbury, MA 01776-1753

Phone

(978) 443-8810

Fax

(978) 443-8839

NPI assigned

Sep 28, 2017

Last updated

Jul 22, 2024By 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 3

Addresses

Other names 1

• Miss Kristy Pooler Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT, MA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Charles River Medical Associates, PCGroup PAC ID 3476630450, 118 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emerson Hospital - Hospital, W Concord, MA, CCN 220084

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristy.poulliot.1@3094.direct.athenahealth.com
• Direct secure messaging: poulliot.kristy.crm@direct.partners.masshiway.net

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.

• Charles River Medical Associates PC

  • Internal Medicine Physician
  • Framingham, MA
  • NPI 1598215204
  Medicare reassignment Care Compare group NPD
• Starting Line Wellness, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Hopkinton, MA
  • NPI 1003373069
  Medicare reassignment NPD
• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053

  Nurse Practitioner

  Medicare reassignment NPD
• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373
  Medicare reassignment
• Charles River Medical Associates PC

  • Sports Medicine (Internal Medicine) Physician
  • Northborough, MA
  • NPI 1710495585
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Emerson Hospital

  • General Acute Care Hospital
  • Concord, MA
  • NPI 1922103357
  Care Compare affiliation

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1689183014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 MAIN ST STE 203B",
            "city": "ASHLAND",
            "state": "MA",
            "postal_code": "017211187",
            "telephone_number": "508-881-3029",
            "fax_number": "508-881-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 HUDSON RD STE 3310",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017761753",
            "telephone_number": "978-443-8810",
            "fax_number": "978-443-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULLIOT",
        "first_name": "KRISTY",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2268086",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2268086",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "7330",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Poulliot.Kristy.CRM@direct.partners.masshiway.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "29 Hudson Rd Ste 3310",
            "city": "Sudbury",
            "state": "MA",
            "country_code": "US",
            "postal_code": "017761753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTY",
            "last_name": "POOLER",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Phillips, LICSW
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• Natalie Marie Pomarico, PTA, LMT
• Post Road Pediatrics,LLP
• Ava Powell, MSW, LICSW
• Isabel Poznanski
• Marilyn A. Rand, M.A., CCC
• John Joseph Reap, MD
• Reina P. Garcia, DMD PC

• Nurse Practitioner in Sudbury, MA
• Providers in Sudbury, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.