TAYLOR JOHNSON ANTONELLIS (FNP-C) – Family Nurse Practitioner, NPI 1144957036

TAYLOR JOHNSON ANTONELLIS (FNP-C) is a healthcare provider. based in Waltham, Massachusetts. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. RN2350068 (MA). The NPI Number for TAYLOR JOHNSON ANTONELLIS (FNP-C) is 1144957036

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
TAYLOR JOHNSON ANTONELLIS (FNP-C)
NPI
1144957036
Phone
(781) 693-3800
Address
43 FOUNDRY AVE
Enumeration Date
2 August 2022
Last Update Date
10 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6177830500
Graduation Year
2022 (4 years ago)
PAC ID
2769850734
Group Practice PAC ID
5294709812
Professional Enrollment ID
I20221122003057
Address ID
MA021351007BR495XXAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Digital endpointsOther names

8,971 NURSE PRACTITIONER in MA

Provider Addresses for TAYLOR JOHNSON ANTONELLIS (FNP-C)

  • 43 FOUNDRY AVE

    WALTHAM, MA 024538313

    Phone: (781) 693-3800

    Type: Location

  • 43 FOUNDRY AVE STE 110

    WALTHAM, MA 024538313

    Phone: (781) 693-3800

    Fax: (617) 562-1398

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $16.

Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.

Last reported payment date: 2024-05-10 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($16).

Total Amount

$16

General + Research + Ownership

Payments

1

Total payment records

General Amount

$16

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-10

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
GlaxoSmithKline, LLC.$16
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-11-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20221122003057INurse PractitionerMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02453)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5294709812View full group profile
NameSpecialtyState
Nurse PractitionerMA
-MA
Nurse PractitionerMA
-MA
-MA
Physician AssistantMA
Physician AssistantMA
Nurse PractitionerMA
Hospitalist, Internal MedicineMA
Internal MedicineMA

Reviews

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Frequently asked questions

Is there an official ID for TAYLOR JOHNSON ANTONELLIS (FNP-C) in U.S. healthcare records?
The official identifier for TAYLOR JOHNSON ANTONELLIS (FNP-C) is NPI 1144957036.
Is there an active status for TAYLOR JOHNSON ANTONELLIS (FNP-C)?
For scheduling context, TAYLOR JOHNSON ANTONELLIS (FNP-C) is shown as active in the registry.
What area of care is associated with TAYLOR JOHNSON ANTONELLIS (FNP-C)?
TAYLOR JOHNSON ANTONELLIS (FNP-C)'s record emphasizes Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is TAYLOR JOHNSON ANTONELLIS (FNP-C) associated with Waltham?
Public fields place TAYLOR JOHNSON ANTONELLIS (FNP-C) around Waltham, Massachusetts. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for TAYLOR JOHNSON ANTONELLIS (FNP-C) is noted as August 2, 2022 where the registry provides it.

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