Lara Bastajian, NP
Individual provider Active NPI Family Nurse Practitioner · Andover, MA
NPI 1922443746 · NPPES record last updated Dec 26, 2024
Key facts
- NPI
- 1922443746
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN2270224 (MA)
- Practice address
- 300 Federal St
Andover, MA 01810-1038 - Phone
- (888) 454-2771
- Fax
- (833) 428-3730
- NPI assigned
- May 7, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
6 Robinson Dr
Bedford, MA 01730-1337
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151008000248 | MA | Practitioner - Nurse Practitioner | 5193033363 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN2270224 | MA | Yes |
Addresses
Primary practice location
300 Federal St
Andover, MA 01810-1038
Mailing address
6 Robinson Dr
Bedford, MA 01730-1337
Phone (617) 930-3992
Other providers in Andover, MA
- Russell S Bard Jr.
- Leya Barden
- Kristen Bardol
- Richard Harris Baron
- Lauren Margaret Barry
- Bear Mt Andover LLC
- Amy Beaulieu
- Mary T Behl
- Marcy Beinert
- Lauren Belanger
All providers in Andover, MA · Family Nurse Practitioner in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.