Individual provider Active NPI

Kayla Rose

  • Nurse Practitioner
  • Medford, MA
National Provider Identifier
1770029670
Registry record updated Mar 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2299577 Issued in MA
Practice address
170 Governors Ave
Medford, MA 02155-1643
Phone
(781) 306-6000
NPI assigned
Jan 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2017

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 RN2299577 MA
Nurse Practitioner 363L00000X RN2299577 MA Primary

Addresses

Primary practice location

170 Governors Ave
Medford, MA 02155-1643

Mailing address

31 Turkey Hill Rd
West Newbury, MA 01985-2009
Phone (978) 406-7309

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
I20170223001496 MA Practitioner - Nurse Practitioner 1355625021 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
Massachusetts Acute Care Specialists PCGroup PAC ID 9234303082, 43 clinicians

Practice addresses (Care Compare)

170 Governors Ave
Medford, MA 02155-1643
Phone (781) 306-6000

2 Corporation Way
Suite 180
Peabody, MA 01960-7996
Phone (978) 532-6111

Hospital & facility affiliations

  • Melrosewakefield Healthcare Hospital, Melrose, MA, CCN 220070
  • Tufts Medical Center Hospital, Boston, MA, CCN 220116

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Aug 1, 2021 Accepting new patients
Massachusetts Acute Care Specialists PC CurrentSince Mar 1, 2017 Accepting new patients
North Shore Medical Center, Inc. Current Accepting new patients

Locations

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

2 Corporation Way
Ste 180
Peabody, MA 01960
Phone (781) 248-1766

Interoperability endpoints

  • Direct secure messaging: krose28892@tuftsmedicine.direct-ci.com
  • Direct secure messaging: rose.kayla.nsmc@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.

Hospital & facility affiliations 2

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": "1484524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490572800000",
    "number": "1770029670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 TURKEY HILL RD",
            "city": "WEST NEWBURY",
            "state": "MA",
            "postal_code": "019852009",
            "telephone_number": "978-406-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 GOVERNORS AVE",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021551643",
            "telephone_number": "781-306-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "KAYLA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-16",
        "last_updated": "2017-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2299577",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2299577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.