Individual provider Active NPI

Yanique Louis

  • Primary Care Nurse Practitioner
  • Malden, MA
National Provider Identifier
1770880643
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
2267342 Issued in MA
Practice address
100 Porter St
Malden, MA 02148-2833
Phone
(617) 259-7032
NPI assigned
Feb 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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 636173 NY
Primary Care Nurse Practitioner 363LP2300X 2267342 MA Primary

Addresses

Primary practice location

100 Porter St
Malden, MA 02148-2833

Mailing address

8825 163Rd St
Jamaica, NY 11432-4046
Phone (718) 739-0045

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
I20191104001436 MA Practitioner - Nurse Practitioner 7012249428 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
636173NYMDRegistered Nurse
2267342MAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc CurrentSince Jul 1, 2022 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
Matrix Medical Plus CurrentSince Feb 1, 2023 Accepting new patients
Harry'S Nurses Registry,Inc Past Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

75 Francis St
Boston, MA 02115

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

3 Allied Dr
Dedham, MA 02026
Phone (404) 587-0945

1153 Centre St
#L1
Jamaica Plain, MA 02130

254 2nd Ave
Ste 100
Needham Heights, MA 02494
Phone (781) 416-8412

Interoperability endpoints

  • Direct secure messaging: louis.yanique.bwh@direct.partners.masshiway.net

Organizations & group practices 7

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": "1297382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1770880643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8825 163RD ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114324046",
            "telephone_number": "718-739-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PORTER ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021482833",
            "telephone_number": "617-259-7032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUIS",
        "first_name": "YANIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-11",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "636173",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "2267342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

Verify at the official NPI Registry.