Individual provider Active NPI

Nicola Tesorero, FNP-C

  • Family Nurse Practitioner
  • Boston, MA
National Provider Identifier
1710345657
Registry record updated Aug 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2298966 Issued in MA
Practice address
30 Northampton St
Boston, MA 02118-4010
Phone
(617) 433-9601
Fax
(617) 445-6538
NPI assigned
Feb 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2298966 MA
Family Nurse Practitioner 363LF0000X RN2298966 MA Primary

Addresses

Primary practice location

30 Northampton St
Boston, MA 02118-4010

Mailing address

30 Northampton St
Boston, MA 02118-4010
Phone (617) 433-9601

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
I20161201000701 MA Practitioner - Nurse Practitioner 6608156047 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bostons Community Medical Group IncGroup PAC ID 1355390691, 31 clinicians

Practice addresses (Care Compare)

30 Northampton St
Boston, MA 02118-4098
Phone (617) 433-9601

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2298966MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Clinical Alliance, Inc CurrentSince Feb 1, 2026 Accepting new patients
Boston'S Community Medical Group, Inc. CurrentSince Oct 12, 2016 Accepting new patients

Locations

30 Northampton St
Roxbury, MA 02118
Phone (617) 433-9601

3550 Main St
Ste 101
Springfield, MA 01107
Phone (413) 739-0669

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1454716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1710345657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 NORTHAMPTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184010",
            "telephone_number": "617-433-9601",
            "fax_number": "617-445-6538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 NORTHAMPTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184010",
            "telephone_number": "617-433-9601",
            "fax_number": "617-445-6538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESORERO",
        "first_name": "NICOLA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-06",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2298966",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2298966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.