Individual provider Active NPI

Lauren Cerulle Pack, NP

  • Nurse Practitioner
  • Northampton, MA
National Provider Identifier
1821537085
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2320498 Issued in MA
Practice address
30 Locust St
Northampton, MA 01060-2052
Phone
(413) 582-2900
NPI assigned
Feb 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Registered Nurse 163WX0200X 703005 NY
Nurse Practitioner 363L00000X 7626 CT
Adult Health Nurse Practitioner 363LA2200X 7626 CT
Gerontology Nurse Practitioner 363LG0600X 7626 CT
Nurse Practitioner 363L00000X RN2320498 MA Primary

Addresses

Primary practice location

30 Locust St
Northampton, MA 01060-2052

Mailing address

30 Locust St
Northampton, MA 01060-2052
Phone (413) 582-2900

Other practice location 1

85 Retreat Ave Ste 2
Hartford, CT 06106
Phone (860) 249-6291

Other practice location 2

525 E 68th St
New York, NY 10065-4870
Phone (212) 746-0329

Other names 1

  • Lauren Nicole Cerulle Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181115002092 CT Practitioner - Nurse Practitioner 6608120399 Reassigns benefits to 2 organizations
I20210526002899 MA Practitioner - Nurse Practitioner 6608120399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

30 Locust St
Northampton, MA 01060-2052
Phone (413) 582-2900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
703005NYMDOncology Registered Nurse
7626CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Western Massachusetts Inc CurrentSince Jun 1, 2021 Accepting new patients
Hartford Hospital CurrentSince Oct 1, 2018 Accepting new patients
Hartford Hospital CurrentSince Oct 1, 2018 Accepting new patients

Locations

85 Retreat Ave
Ste 2
Hartford, CT 06106
Phone (860) 249-6291

30 Locust St
Northampton, MA 01060
Phone (413) 582-2000

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.

Hospital & facility affiliations 2

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": "1487548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1821537085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 LOCUST ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010602052",
            "telephone_number": "413-582-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 LOCUST ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010602052",
            "telephone_number": "413-582-2900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 Retreat Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "06106",
            "country_code": "US",
            "telephone_number": "860-249-6291",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 E 68th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100654870",
            "country_code": "US",
            "telephone_number": "212-746-0329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACK",
        "first_name": "LAUREN",
        "middle_name": "CERULLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-20",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "NY",
            "license": "703005",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "7626",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "7626",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "7626",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2320498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "CERULLE",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Northampton, MA

Sources for this page

Verify at the official NPI Registry.