Individual provider Active NPI

Patricia Reidy, NP

  • Family Nurse Practitioner
  • Dorchester, MA
National Provider Identifier
1770568412
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
128253 Issued in MA
Practice address
250 Mount Vernon St
Dorchester, MA 02125-3120
Phone
(617) 288-1140
Fax
(617) 288-3910
NPI assigned
Dec 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 128253 MA Primary

Addresses

Primary practice location

250 Mount Vernon St
Dorchester, MA 02125-3120

Mailing address

15 Makos St
Tyngsboro, MA 01879-1271
Phone (978) 649-9668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
128253MAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1770568412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MAKOS ST",
            "city": "TYNGSBORO",
            "state": "MA",
            "postal_code": "018791271",
            "telephone_number": "978-649-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MOUNT VERNON ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021253120",
            "telephone_number": "617-288-1140",
            "fax_number": "617-288-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIDY",
        "first_name": "PATRICIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "128253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.