Individual provider Active NPI

Juliana Antonucci

  • Family Nurse Practitioner
  • Cambridge, MA
National Provider Identifier
1821717877
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2328693 Issued in MA
Practice address
119 Windsor St
Cambridge, MA 02139-3647
Phone
(617) 665-3600
NPI assigned
Aug 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2328693 MA Primary
Registered Nurse 163W00000X RN2328693 MA

Addresses

Primary practice location

119 Windsor St
Cambridge, MA 02139-3647

Mailing address

9 Highland St
Waltham, MA 02453-3454

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
I20240912002493 MA Practitioner - Nurse Practitioner 7911447248 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission Current Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jan 6, 2025 Accepting new patients
Cape Ann Medical Center LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

155 Federal St
Ste 700
Boston, MA 02110
Phone (469) 466-7420

119 Windsor St
Cambridge, MA 02139
Phone (617) 665-3600

1 Blackburn Dr
Gloucester, MA 01930
Phone (978) 282-3698

1 Blackburn Dr
Ste 1
Gloucester, MA 01930

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: jantonucci115441@direct.challiance.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": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1821717877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 HIGHLAND ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024533454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 WINDSOR ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393647",
            "telephone_number": "617-665-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONUCCI",
        "first_name": "JULIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2328693",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2328693",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.