Active NPI
Denise D Gauthier, NP
- Nurse Practitioner
- Boston, MA
National Provider Identifier
1780746248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 167109
- Practice address
- 55 Fruit Street Bul 105
MGH Cardiac Unit Associates
Boston, MA 02114 - Phone
- (617) 726-9292
- NPI assigned
- Dec 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 167109 | MA | Primary |
Addresses
Primary practice location
55 Fruit Street Bul 105
MGH Cardiac Unit Associates
Boston, MA 02114
Mailing address
PO Box 9142
Mass General Physicians Organization Inc
Charlestown, MA 02129-9142
Phone (617) 724-0287
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NP3480 | Other | MA | BLUE SHIELD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 167109 | MA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780746248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9142",
"address_2": "MASS GENERAL PHYSICIANS ORGANIZATION INC",
"city": "CHARLESTOWN",
"state": "MA",
"postal_code": "021299142",
"telephone_number": "617-724-0287"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT STREET BUL 105",
"address_2": "MGH CARDIAC UNIT ASSOCIATES",
"city": "BOSTON",
"state": "MA",
"postal_code": "02114",
"telephone_number": "617-726-9292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUTHIER",
"first_name": "DENISE",
"middle_name": "D",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "167109",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "NP3480",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.