Individual provider Active NPI

Gillian Bernstein, CPNP-PC

  • Pediatric Nurse Practitioner
  • Boston, MA
National Provider Identifier
1770072258
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN2289034 Issued in MA
Practice address
45 Dimock St
Boston, MA 02119-1208
Phone
(617) 442-8800
Fax
(617) 442-5840
NPI assigned
May 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN2289034 MA Primary

Addresses

Primary practice location

45 Dimock St
Boston, MA 02119-1208

Mailing address

45 Dimock St
Roxbury, MA 02119-1208
Phone (617) 442-8800

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
I20180727001872 MA Practitioner - Nurse Practitioner 6901153568 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2289034MAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dimock Community Health Center, Inc CurrentSince Jul 2, 2018 Accepting new patients
Dimock Community Health Center, Inc CurrentSince Jul 2, 2018 Accepting new patients

Locations

45 Dimock St
Roxbury, MA 02119

45 Dimock St
Fl 1
Roxbury, MA 02119

55 Dimock St
Roxbury, MA 02119

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": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1770072258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 DIMOCK ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191208",
            "telephone_number": "617-442-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 DIMOCK ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021191208",
            "telephone_number": "617-442-8800",
            "fax_number": "617-442-5840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNSTEIN",
        "first_name": "GILLIAN",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-09",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2289034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.