Individual provider Active NPI

Nicholas Larsen, CPNP-PC

  • Pediatric Nurse Practitioner
  • Brookline, MA
National Provider Identifier
1902321250
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN2306931 Issued in MA
Practice address
1 Brookline PL Ste 327
Brookline, MA 02445-7238
Phone
(617) 735-8585
NPI assigned
Aug 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN2306931 MA Primary

Addresses

Primary practice location

1 Brookline PL Ste 327
Brookline, MA 02445-7238

Mailing address

1 Brookline PL Ste 327
Brookline, MA 02445-7238
Phone (617) 735-8585

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2306931MAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Hospital Boston Past Accepting new patients
Centre Pediatric Associates PC PastSince Jul 24, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nlarsen28115@direct.bostonchildrens.org

Organizations & group practices 2

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": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1902321250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BROOKLINE PL STE 327",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457238",
            "telephone_number": "617-735-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKLINE PL STE 327",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457238",
            "telephone_number": "617-735-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "NICHOLAS",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2306931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.