Individual provider Active NPI

Stacey A Lerager, NP

  • Nurse Practitioner
  • Brighton, MA
National Provider Identifier
1790747392
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
145912 Issued in MA
Practice address
77 Warren St
Brighton, MA 02135-3601
Phone
(617) 562-5359
Fax
(617) 562-5415
NPI assigned
Apr 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 145912 MA Primary

Addresses

Primary practice location

77 Warren St
Brighton, MA 02135-3601

Mailing address

77 Warren St
Brighton, MA 02135-3601
Phone (617) 562-5359

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
I20050614000461 MA Practitioner - Nurse Practitioner 7810931508 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
145912MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Steward St. Elizabeth'S Medical Center of Boston, Inc. CurrentSince Nov 6, 2010 Accepting new patients
Steward St. Elizabeth'S Medical Center of Boston, Inc. CurrentSince Nov 6, 2010 Accepting new patients

Locations

77 Warren St
Brighton, MA 02135
Phone (617) 254-1271

77 Warren St
Fl 2
Brighton, MA 02135
Phone (617) 562-5525

77 Warren St
Fl 1
Brighton, MA 02135
Phone (617) 562-5200

Organizations & group practices 2

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1790747392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 WARREN ST",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353601",
            "telephone_number": "617-562-5359",
            "fax_number": "617-562-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 WARREN ST",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353601",
            "telephone_number": "617-562-5359",
            "fax_number": "617-562-5415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERAGER",
        "first_name": "STACEY",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "145912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.