Active NPI
Natalie Maibenko, LE
- Public Health & General Preventive Medicine Physician
- Boston, MA
National Provider Identifier
1871355503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- 6004926
- Practice address
- 264 Beacon St Ste 4F
Boston, MA 02116-1236 - Phone
- (617) 595-2510
- NPI assigned
- Jan 29, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | 6004926 | MA | Primary |
Addresses
Primary practice location
264 Beacon St Ste 4F
Boston, MA 02116-1236
Mailing address
280 Boylston St Apt 308
Chestnut Hill, MA 02467-1903
Phone (857) 540-9465
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6004926 | MA | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706486400000",
"number": "1871355503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 BOYLSTON ST APT 308",
"city": "CHESTNUT HILL",
"state": "MA",
"postal_code": "024671903",
"telephone_number": "857-540-9465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "264 BEACON ST STE 4F",
"city": "BOSTON",
"state": "MA",
"postal_code": "021161236",
"telephone_number": "617-595-2510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAIBENKO",
"first_name": "NATALIE",
"credential": "LE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-29",
"last_updated": "2024-01-29",
"certification_date": "2024-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "MA",
"license": "6004926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.