Individual provider Active NPI

Kristen Martin, NP

  • Nurse Practitioner
  • Woburn, MA
National Provider Identifier
1912448622
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN283929 Issued in MA
Practice address
400 Unicorn Park Dr
4TH Floor
Woburn, MA 01801-3365
Phone
(781) 338-7521
Fax
(781) 338-7525
NPI assigned
Mar 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN283929 MA Primary

Addresses

Primary practice location

400 Unicorn Park Dr
4TH Floor
Woburn, MA 01801-3365

Mailing address

400 Unicorn Park Dr
4TH Floor
Woburn, MA 01801-3365
Phone (781) 338-7521

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
I20170412000575 MA Practitioner - Nurse Practitioner 4486930179 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hallmark Health Medical Associates Inc CurrentSince Mar 17, 2017 Accepting new patients

Locations

425 Revere St
Revere, MA 02151
Phone (781) 286-1313

400 Unicorn Park Dr
Fl 4
Woburn, MA 01801
Phone (781) 338-7521

Organizations & group practices 1

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": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1912448622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 UNICORN PARK DR",
            "address_2": "4TH FLOOR",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018013365",
            "telephone_number": "781-338-7521",
            "fax_number": "781-338-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 UNICORN PARK DR",
            "address_2": "4TH FLOOR",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018013365",
            "telephone_number": "781-338-7521",
            "fax_number": "781-338-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KRISTEN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-14",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN283929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

Verify at the official NPI Registry.