Individual provider Active NPI

Larissa Engleman, NP

  • Nurse Practitioner
  • Waltham, MA
National Provider Identifier
1790838704
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
236065 Issued in MA
Practice address
950 Winter St
Suite 3800
Waltham, MA 02451-1424
Phone
(781) 472-8594
NPI assigned
Jan 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 236065 MA Primary

Addresses

Primary practice location

950 Winter St
Suite 3800
Waltham, MA 02451-1424

Mailing address

10 Dana St
#508
Cambridge, MA 02138-5411
Phone (617) 868-2806

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
I20050630000325 MA Practitioner - Nurse Practitioner 5890731756 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hebrew Rehabilitation CenterGroup PAC ID 6608855119, 49 clinicians

Practice addresses (Care Compare)

1200 Centre St
Roslindale, MA 02131-1000
Phone (617) 363-8010

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 754-8612

482 Bedford St
Lexington, MA 02420-1402
Phone (781) 983-9088

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
236065MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jun 28, 2010 Accepting new patients
Hebrew Rehabilitation Center CurrentSince Feb 29, 2024 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jun 28, 2010 Accepting new patients
Hebrew Rehabilitation Center CurrentSince Feb 29, 2024 Accepting new patients

Locations

330 Brookline Ave
#7
Boston, MA 02215
Phone (617) 632-7483

185 Pilgrim Rd
#1
Boston, MA 02215
Phone (617) 632-0908

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

7000 Great Meadow Rd
Dedham, MA 02026
Phone (781) 234-9600

1200 Centre St
Roslindale, MA 02131
Phone (617) 363-8000

Interoperability endpoints

  • Direct secure messaging: lengleman252935@direct.bilh.masshiway.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1169337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790838704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DANA ST",
            "address_2": "#508",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385411",
            "telephone_number": "617-868-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 WINTER ST",
            "address_2": "SUITE 3800",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511424",
            "telephone_number": "781-472-8594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGLEMAN",
        "first_name": "LARISSA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "236065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.