Individual provider Active NPI

Katie A Deary, NP

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1801921275
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
263797 Issued in MA
Practice address
110 Francis Street
Lowry Building 6TH Floor Suite 6E
Boston, MA 02215-2371
Phone
(617) 632-7500
NPI assigned
Feb 23, 2007
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 263797 MA Primary

Addresses

Primary practice location

110 Francis Street
Lowry Building 6TH Floor Suite 6E
Boston, MA 02215-2371

Mailing address

110 Francis Street
Lowry Building 6TH Floor Suite 6E
Boston, MA 02215-2371

Other practice location 1

830 Harrison Ave
Moakley 1400
Boston, MA 02118-2905
Phone (617) 638-8124

Other practice location 2

830 Harrison Ave
Moakley 1400
Boston, MA 02118-2905
Phone (617) 638-8124

Other names 1

  • Katie A. McDonough Former name

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
I20150803000851 MA Practitioner - Nurse Practitioner 9537382361 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr IncGroup PAC ID 4486567104, shared by 12 NPIs, 1,693 clinicians

Practice addresses (Care Compare)

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 667-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
263797MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Current Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Sep 19, 2017 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Sep 19, 2017 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Sep 19, 2017 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Sep 1, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Sep 19, 2017 Accepting new patients

Locations

110 Francis St
Ste 6E
Boston, MA 02215
Phone (617) 632-7300

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

Organizations & group practices 6

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1801921275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 FRANCIS STREET",
            "address_2": "LOWRY BUILDING 6TH FLOOR SUITE 6E",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022152371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 FRANCIS STREET",
            "address_2": "LOWRY BUILDING 6TH FLOOR SUITE 6E",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022152371",
            "telephone_number": "617-632-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 Harrison Ave",
            "address_2": "Moakley 1400",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182905",
            "country_code": "US",
            "telephone_number": "617-638-8124",
            "fax_number": "617-638-6424",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "830 Harrison Ave",
            "address_2": "Moakley 1400",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182905",
            "country_code": "US",
            "telephone_number": "617-638-8124",
            "fax_number": "617-638-6424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEARY",
        "first_name": "KATIE",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "263797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "MCDONOUGH",
            "middle_name": "A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.