Hannah E Boutselis, APRN
Individual provider Active NPI Family Nurse Practitioner · Manchester, NH
NPI 1730675562 · NPPES record last updated Oct 31, 2018
Key facts
- NPI
- 1730675562
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 066272-23 (NH)
- Practice address
- 1750 Elm St.
Suite 201a
Manchester, NH 03104 - Phone
- (603) 623-3343
- Fax
- (603) 623-7924
- NPI assigned
- Jul 4, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Appledore Medical Group Inc
Practice addresses (Care Compare)
57 Webster St
Suite 110
Manchester, NH 03104-2552
Phone (603) 622-6491
Hospital & facility affiliations
- Granite Vna, Inc
- Vna Home Health and Hospice Services, Inc
- Interim Healthcare
- Catholic Medical Center
- Elliot Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180928001079 | NH | Practitioner - Nurse Practitioner | 7810248960 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 066272-23 | NH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catholic Medical Center | Current |
Accepting new patients | |
| Appledore Medical Group, Inc | Current |
Accepting new patients | |
| Appledore Medical Group Dba Woodbury Family Practice | Current |
Accepting new patients | |
| Catholic Medical Center | Current |
Accepting new patients | |
| Appledore Medical Group, Inc. | Past | Accepting new patients |
Locations
5 Washington Pl
Ste 1A
Bedford, NH 03110
Phone (603) 663-8060
57 Webster St
Ste 110
Manchester, NH 03104
Phone (603) 622-6491
57 Webster St
Manchester, NH 03104
Phone (603) 622-6491
1750 Elm St
Ste 201A
Manchester, NH 03104
Phone (603) 623-3343
330 Borthwick Ave
Ste 308
Portsmouth, NH 03801
Phone (603) 431-5242
330 Borthwick Ave
Ste 201
Portsmouth, NH 03801
Phone (603) 431-5242
2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426
Interoperability endpoints
- hannah.boutselis@hca6.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 066272-23 | NH | Yes |
Addresses
Primary practice location
1750 Elm St.
Suite 201a
Manchester, NH 03104
Mailing address
1750 Elm St.
Suite 201a
Manchester, NH 03104
Phone (603) 623-3343
Other names
- Hannah Elizabeth Dubois
Other providers in Manchester, NH
- Jamie J Bourgeois
- Amy Regina Bourne
- Kimberly Marie Bouse
- Michelle Boutin
- Amanda Boutrus
- Samantha Corinne Boutsianis
- Samantha M Bouvier
- Caitlin Bova
- Kayleen Bowden
- Natasha May Bowden
All providers in Manchester, NH · Family Nurse Practitioner in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.