Individual provider Active NPI

Charlotte Robertshaw, NP

  • Primary Care Nurse Practitioner
  • Boston, MA
National Provider Identifier
1780378406
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN10011774 Issued in MA
Practice address
53 State St
Boston, MA 02109-2820
Phone
(617) 903-5000
Fax
(415) 252-7176
NPI assigned
Jun 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X NP95023334 CA
Primary Care Nurse Practitioner 363LP2300X RN10011774 MA Primary

Addresses

Primary practice location

53 State St
Boston, MA 02109-2820

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723

Other practice location 1

350 Bon Air
#200
Larkspur, CA 94904
Phone (415) 578-3095

Other practice location 2

350 Bon Air Ctr Ste 200
Greenbrae, CA 94904-3000
Phone (888) 663-6331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230713003212 CA Practitioner - Nurse Practitioner 1254791833
I20250108002634 MA Practitioner - Nurse Practitioner 1254791833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mass General Brigham Community Physicians IncGroup PAC ID 1759273436, 430 clinicians

Practice addresses (Care Compare)

53 State St
Suite 106
Boston, MA 02109-2820
Phone (617) 903-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95023334CAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Community Physicians Inc CurrentSince Feb 10, 2025 Accepting new patients
Mass General Brigham Community Physicians Inc. CurrentSince Feb 10, 2025 Accepting new patients
Mass General Brigham Community Physicians Inc. Current Accepting new patients
Mass General Brigham Community Physicians Inc. Past Accepting new patients

Locations

53 State St
Ste 106
Boston, MA 02109

399 Revolution Dr
Ste 1010
Somerville, MA 02145
Phone (857) 282-2063

Organizations & group practices 4

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": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1780378406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 STATE ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021092820",
            "telephone_number": "617-903-5000",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Bon Air",
            "address_2": "#200",
            "address_purpose": "LOCATION",
            "city": "Larkspur",
            "state": "CA",
            "postal_code": "94904",
            "country_code": "US",
            "telephone_number": "415-578-3095",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Bon Air Ctr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Greenbrae",
            "state": "CA",
            "postal_code": "949043000",
            "country_code": "US",
            "telephone_number": "888-663-6331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTSHAW",
        "first_name": "CHARLOTTE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-06",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "NP95023334",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "RN10011774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.