ERLINE DESTRA (NP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1619120490

ERLINE DESTRA (NP) is a healthcare provider. based in Somerville, Massachusetts. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. RN2316809 (MA). The NPI Number for ERLINE DESTRA (NP) is 1619120490

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
ERLINE DESTRA (NP)
NPI
1619120490
Phone
(781) 584-3693
Address
445 ARTISAN WAY APT 426
Enumeration Date
24 October 2008
Last Update Date
25 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8576541850
Graduation Year
2023 (3 years ago)
PAC ID
2264896919
Group Practice PAC ID
2668475419
Professional Enrollment ID
I20230913002163
Address ID
MA021182404BO444XXAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience77
Completeness75
Years active:17State licenses:2Digital endpointsOther names

8,971 NURSE PRACTITIONER in MA

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Provider Addresses for ERLINE DESTRA (NP)

  • 445 ARTISAN WAY APT 426

    SOMERVILLE, MA 02145

    Phone: (781) 584-3693

    Type: Mailing

  • Cary W. Akins Pavilion, 780, Albany Street, South End, Boston, Suffolk County, Massachusetts, 02118, United States

    BOSTON, MA 021182755

    Phone: (857) 654-1000

    Type: Location

  • 780 ALBANY ST

    BOSTON, MA 021182755

    Phone: (857) 654-1000

    Fax: (857) 654-1100

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2023-09-13

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
I20230913002163INurse 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 02145)

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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: 2668475419View full group profile
NameSpecialtyState
Clinical Social WorkerMA
O P T O M E T R YMA
Internal MedicineMA
Nurse PractitionerMA
-MA
-MA
Internal MedicineMA
Clinical Social WorkerMA
Physician AssistantMA
Physician AssistantMA

Reviews

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Frequently asked questions

What federal number belongs to ERLINE DESTRA (NP)?
The federal identifier for ERLINE DESTRA (NP) is NPI 1619120490.
Is ERLINE DESTRA (NP)'s NPI currently valid?
The extract we use shows ERLINE DESTRA (NP) as active.
What kind of provider is ERLINE DESTRA (NP)?
The page reflects Psychiatric/Mental Health Nurse Practitioner for ERLINE DESTRA (NP). Clinical services aligned with this taxonomy classification.
What location shows for ERLINE DESTRA (NP)?
We surface Somerville, Massachusetts for ERLINE DESTRA (NP) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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