Individual provider Active NPI

Linda K Kelly, ANP

  • Adult Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1700119682
Registry record updated Sep 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN181788 Issued in MA
Practice address
55 Friut Street
Boston, MA 02114-2621
Phone
(617) 726-5290
Fax
(617) 726-4803
NPI assigned
Sep 10, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN181788 MA Primary

Addresses

Primary practice location

55 Friut Street
Boston, MA 02114-2621

Mailing address

55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-5290

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
I20091214000159 MA Practitioner - Nurse Practitioner 4486794047 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Jul 1, 2016 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Oct 15, 2009 Accepting new patients
General Hospital Corp Current Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Interoperability endpoints

  • Direct secure messaging: kelly.linda.mgh@direct.partners.masshiway.net

Organizations & group practices 3

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": "1252540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252540800000",
    "number": "1700119682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-5290",
            "fax_number": "617-726-4803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRIUT STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-5290",
            "fax_number": "617-726-4803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LINDA",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-10",
        "last_updated": "2009-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN181788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.