NPIMap

Individual provider Active NPI

Arlene K Dermovsesian, N.P.

  • Adult Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1720050883
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN201093 Issued in MA
Practice address
830 Harrison Ave
Suite 3500
Boston, MA 02118-2309
Phone
(617) 638-8776
Fax
(617) 414-8772
NPI assigned
Feb 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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 RN201093 MA Primary

Addresses

Primary practice location

830 Harrison Ave
Suite 3500
Boston, MA 02118-2309

Mailing address

960 Massachusetts Ave
FL 2
Boston, MA 02118

Other identifiers 2

IdentifierTypeStateIssuer
110020046AMedicaidMA
3117712MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050705000261 MA Practitioner - Nurse Practitioner 5698711380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Evans Medical Foundation IncGroup PAC ID 7416946546, 525 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-8000

72 E Newton St
CR Evans 124
Boston, MA 02118-2308
Phone (617) 638-7253

88 E Newton St
Boston, MA 02118-2308
Phone (617) 414-5405

Hospital & facility affiliations

  • Boston Medical Center Hospital, Boston, MA, CCN 220031
  • Sturdy Memorial Hospital Hospital, Attleboro, MA, CCN 220008

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Evans Medical Foundation, Inc. Adult Health CurrentSince Apr 5, 2001 Accepting new patients
Boston University General Surgical Associates, Inc. PastSince Mar 1, 2020 Accepting new patients

Locations

1 Boston Medical Ctr Pl
#1
Boston, MA 02118
Phone (617) 414-4929

960 Massachusetts Ave
Ste 2
Boston, MA 02118

88 Newton St
Boston, MA 02118
Phone (617) 638-7350

732 Harrison Ave
Fl 3
Boston, MA 02118
Phone (617) 638-5350

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

Interoperability endpoints

  • Direct secure messaging: adermovsesian10024@direct.bmc.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.

Hospital & facility affiliations 9

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1720050883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 HARRISON AVE",
            "address_2": "SUITE 3500",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182309",
            "telephone_number": "617-638-8776",
            "fax_number": "617-414-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERMOVSESIAN",
        "first_name": "ARLENE",
        "middle_name": "K",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN201093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110020046A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3117712",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.