NPIMap

Individual provider Active NPI

Therese M Lizzotte, NP

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1780182329
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2306553 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 726-4280
NPI assigned
Jan 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 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 RN2306553 MA
Nurse Practitioner 363L00000X RN2306553 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

11 Mason St
Everett, MA 02149-3109

Other practice location 1

21 Maypole Rd
Quincy, MA 02169-2311
Phone (617) 406-9520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190226003278 MA Practitioner - Nurse Practitioner 5698014223 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Mass General Brigham Urgent Care LLCGroup PAC ID 9436470119, 106 clinicians

Practice addresses (Care Compare)

1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 739-6950

137 Stuart St
Suite A7
Boston, MA 02116-5609
Phone (617) 393-5059

71 Needham St
Newton, MA 02461-1663
Phone (857) 598-4460

90 Brigham Way
Westwood, MA 02090-2444
Phone (774) 231-1941

Hospital & facility affiliations

  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2306553MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Urgent Care LLC CurrentSince Jan 17, 2023 Accepting new patients
General Hospital Corp Current Accepting new patients
The General Hospital Corporation CurrentSince Jan 16, 2019 Accepting new patients
Mass General Brigham Urgent Care LLC Current Accepting new patients
Mass General Brigham Urgent Care LLC CurrentSince Jan 17, 2023 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Jan 16, 2019 Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Jan 28, 2026 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

1285 Beacon St
Brookline, MA 02446
Phone (617) 751-6205

71 Needham St
Newton, MA 02461
Phone (617) 712-2770

Interoperability endpoints

  • Direct secure messaging: lizzotte.therese.puc@direct.partners.masshiway.net
  • Direct secure messaging: lizzotte.therese.mgh@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.

Hospital & facility affiliations 3

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": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1780182329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MASON ST",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021493109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-4280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Maypole Rd",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "MA",
            "postal_code": "021692311",
            "country_code": "US",
            "telephone_number": "617-406-9520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIZZOTTE",
        "first_name": "THERESE",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-29",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2306553",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2306553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.