Individual provider Active NPI

Katie Brouillard O'Brien, NP

  • Dermatology Physician
  • Worcester, MA
National Provider Identifier
1801048921
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
284603 Issued in MA
Practice address
255 Park Ave Ste 509
Worcester, MA 01609-1989
Phone
(508) 890-5500
Fax
(508) 890-5505
NPI assigned
Oct 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 284603 MA
Dermatology Physician 207N00000X 284603 MA Primary

Addresses

Primary practice location

255 Park Ave Ste 509
Worcester, MA 01609-1989

Mailing address

36 Adams Street
Quincy, MA 02169
Phone (617) 773-0711

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
I20081119000312 MA Practitioner - Nurse Practitioner 3375603459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Dermatology of Worcester II LLCGroup PAC ID 0042616153, 2 clinicians

Practice addresses (Care Compare)

255 Park Ave
Suite 509
Worcester, MA 01609-1989
Phone (508) 890-5500

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
284603MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Dermatology of Worcester II LLC Dermatology CurrentSince Mar 1, 2025 Accepting new patients

Locations

405 Grove St
Ste 304
Worcester, MA 01605
Phone (508) 762-9136

255 Park Ave
Ste 509
Worcester, MA 01609
Phone (508) 754-7799

Interoperability endpoints

  • Direct secure messaging: kobrien@directaddress.net
  • Direct secure messaging: kobrien@apderm.emadirect.md

Organizations & group practices 1

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": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1801048921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 ADAMS STREET",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "02169",
            "telephone_number": "617-773-0711",
            "fax_number": "617-376-2271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 PARK AVE STE 509",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091989",
            "telephone_number": "508-890-5500",
            "fax_number": "508-890-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "KATIE",
        "middle_name": "BROUILLARD",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "284603",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "284603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.