Individual provider Active NPI

Deborah Ann Nolan, NP

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1811958135
Registry record updated May 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
115193 Issued in MA
Practice address
100 N Beacon St
Boston, MA 02134
Phone
(617) 726-9700
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 115193 MA
Nurse Practitioner 363L00000X 115193 MA Primary

Addresses

Primary practice location

100 N Beacon St
Boston, MA 02134

Mailing address

PO Box 9142
Charlestown, MA 02129-9142
Phone (617) 726-3884

Other practice location 1

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

Other identifiers 3

IdentifierTypeStateIssuer
N340OtherMAHARVARD PILGRIM
0370410MedicaidMA
NP1167OtherMABLUE CROSS

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
I20050923000944 MA Practitioner - Nurse Practitioner 5193759512 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
115193MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince May 1, 2018 Accepting new patients
The Spaulding Rehabilitation Hospital Corporation Current Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince May 1, 2018 Accepting new patients

Locations

100 North Beacon St
Boston, MA 02134
Phone (617) 726-9700

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Interoperability endpoints

  • Direct secure messaging: nolan.deborah.srb@direct.partners.masshiway.net

Organizations & group practices 3

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1811958135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9142",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021299142",
            "telephone_number": "617-726-3884",
            "fax_number": "617-643-7941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N BEACON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02134",
            "telephone_number": "617-726-9700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 Brookline Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "022153904",
            "country_code": "US",
            "telephone_number": "617-421-1000",
            "fax_number": "617-421-6084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "115193",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "115193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "N340",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0370410",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "NP1167",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.