Individual provider Active NPI

Joan Moira Ronan, NP

  • Pediatric Nurse Practitioner
  • Boston, MA
National Provider Identifier
1922275924
Registry record updated May 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
271635 Issued in MA
Practice address
300 Longwood Ave
Main Building 6North
Boston, MA 02115-5724
Phone
(617) 355-7230
Fax
(617) 730-0874
NPI assigned
May 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2008

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 271635 MA Primary

Addresses

Primary practice location

300 Longwood Ave
Main Building 6North
Boston, MA 02115-5724

Mailing address

60 Dwight St
#1
Brookline, MA 02446-3339
Phone (916) 752-7208

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
271635MAMDPediatrics Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1922275924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 DWIGHT ST",
            "address_2": "#1",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463339",
            "telephone_number": "916-752-7208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "MAIN BUILDING 6NORTH",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-7230",
            "fax_number": "617-730-0874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONAN",
        "first_name": "JOAN",
        "middle_name": "MOIRA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-09",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "271635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.