KELLEY LAVINE (APRN) – Critical Care Neonatal Nurse Practitioner, NPI 1477867455
Critical Care Neonatal Nurse Practitioner
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for KELLEY LAVINE (APRN)
98 LINCOLN RD
SUTTON, MA 015903716
Phone: (508) 865-3613
Type: Mailing
101 DUDLEY ST
PROVIDENCE, RI 029052401
Phone: (401) 274-1122
Type: Location
PO BOX 415348
BOSTON, MA 022415348
Phone: (800) 225-8885
Fax: (508) 334-1977
Type: Mailing
119 BELMONT ST
WORCESTER, MA 016052903
Phone: (508) 334-6206
Fax: (508) 334-6083
Type: Location
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: 2021-02-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180712002991 | I | Nurse Practitioner | CT | TBD |
| I20210222000239 | I | Nurse Practitioner | MA | TBD |
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.
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 01590)
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