Individual provider Active NPI

Kathleen Polson, NP

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1710966924
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
251947 Issued in MA
Practice address
44 Binney St
SW 540
Boston, MA 02115-6013
Phone
(617) 632-5204
Fax
(617) 632-3408
NPI assigned
Jan 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 251947 MA Primary

Addresses

Primary practice location

44 Binney St
SW 540
Boston, MA 02115-6013

Mailing address

158 W Newton St Apt 1
Boston, MA 02118-1203
Phone (617) 536-0031

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
I20160627001679 MA Order and Referring Only - Nurse Practitioner 4385536143

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dana-Farber Cancer Institute, Inc. Current Accepting new patients
Caritas Medical Group, Inc. Past Accepting new patients

Locations

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

450 Brookline Ave
#1212
Boston, MA 02215
Phone (617) 632-4802

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

Interoperability endpoints

  • Direct secure messaging: polson.kathleen.dfci@direct.partners.masshiway.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710966924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 W NEWTON ST APT 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021181203",
            "telephone_number": "617-536-0031",
            "fax_number": "617-632-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 BINNEY ST",
            "address_2": "SW 540",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156013",
            "telephone_number": "617-632-5204",
            "fax_number": "617-632-3408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLSON",
        "first_name": "KATHLEEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "251947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.