Individual provider Active NPI

Michelle Tiffany Letendre, APRN

  • Primary Care Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1770736159
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
205174 Issued in MA
Practice address
70 James St Ste 253
Worcester, MA 01603-1038
Phone
(508) 578-2010
Fax
(508) 578-2012
NPI assigned
Oct 29, 2008
Last updated
Feb 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 205174 MA
Critical Care Neonatal Nurse Practitioner 363LN0005X 002769 CT
Primary Care Nurse Practitioner 363LP2300X 205174 MA Primary
Lactation Consultant (Registered Nurse) 163WL0100X 205174 MA

Addresses

Primary practice location

70 James St Ste 253
Worcester, MA 01603-1038

Mailing address

70 James St Ste 253
Worcester, MA 01603-1038
Phone (508) 578-2010

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

State licenses

LicenseStateTypeSpecialty
002769CTMDPhysician Assistant
002769NYMDMedical Physician Assistant
205174MAMDPrimary Care Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: michelle.letendre.2@1694.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1770736159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 JAMES ST STE 253",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016031038",
            "telephone_number": "508-578-2010",
            "fax_number": "508-578-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 JAMES ST STE 253",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016031038",
            "telephone_number": "508-578-2010",
            "fax_number": "508-578-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETENDRE",
        "first_name": "MICHELLE",
        "middle_name": "TIFFANY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-29",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MA",
            "license": "205174",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "CT",
            "license": "002769",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "205174",
            "primary": true
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MA",
            "license": "205174",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; 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.