Nicole Anne Desrosiers, N.P.
Individual provider Active NPI Family Nurse Practitioner · Boston, MA
NPI 1811167992 · NPPES record last updated Mar 5, 2008
Key facts
- NPI
- 1811167992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 236640 (MA)
- Practice address
- 330 Brookline Ave
Stoneman 10
Boston, MA 02215-5400 - Phone
- (617) 667-3940
- NPI assigned
- Mar 5, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc
Practice addresses (Care Compare)
330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 754-8612
Hospital & facility affiliations
- Beth Israel Deaconess Medical Center
- New England Baptist Hospital
- Beth Israel Deaconess Hospital Plymouth
- Spaulding Rehabilitation Hospital - Cape Cod
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080428000052 | MA | Practitioner - Nurse Practitioner | 4587742820 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 236640 | MA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beth Israel Deaconess Medical Center, Inc. | Current |
Accepting new patients | |
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Current |
Accepting new patients | |
| Beth Israel Deaconess Medical Center, Inc. | Current |
Accepting new 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 | Current | Accepting new patients | |
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Current |
Accepting new patients |
Locations
330 Brookline Ave
#10
Boston, MA 02215
Phone (617) 667-2295
330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000
Interoperability endpoints
- ndesrosiers253635@direct.bilh.masshiway.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 236640 | MA | Yes |
Addresses
Primary practice location
330 Brookline Ave
Stoneman 10
Boston, MA 02215-5400
Mailing address
330 Brookline Ave
Stoneman 10
Boston, MA 02215-5400
Phone (617) 667-3940
Other providers in Boston, MA
- Saradonie Desrivieres
- Laura Desrochers
- Stephanie Desroches
- Katelyn Desrosiers
- Kieley Anne Desrosiers
- Justine Dessalines
- Desta Lissanu MD, LLC
- Nicholas R Destefino
- Nindra Destine
- Erline Destra
All providers in Boston, MA · Family Nurse Practitioner in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.