MRS. ALEXANDRA CATHERINE DISTASO FNP-BC
NPI 1710367560
Nurse Practitioner - Family in Boston, MA

Q: What is Alexandra Distaso's NPI number?

The NPI number for Alexandra Distaso is 1710367560. It was assigned to this individual provider in the NPPES registry on June 8, 2015. The provider is also known as Ms. Alexandra Catherine Mulloy Fnp-Bc.

Q: What is Alexandra Distaso's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Alexandra Distaso was last updated on May 6, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 08, 2015PECOS Enrolled

450 BROOKLINE AVE, BOSTON, MA 02215(617) 632-4218(617) 632-6624 Get Directions Write a Review

NPPES record last updated: May 6, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 6, 2020, Aug 15, 2016 (2 updates tracked since 2016).

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About Mrs. Alexandra Catherine Distaso Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. ALEXANDRA CATHERINE DISTASO FNP-BC (NPI 1710367560) is an individual family provider in Boston, Massachusetts, licensed in Massachusetts (RN2280088) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710367560

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMRS. ALEXANDRA CATHERINE DISTASOCredential: FNP-BC

Location Address450 BROOKLINE AVEBoston, MA 02215-5418

Mailing Address450 Brookline AveBoston, MA 02215-5418 · (617) 632-4218 · Fax (617) 632-6624

Phone(617) 632-4218

Fax(617) 632-6624

Sole ProprietorNo

Enumeration DateJune 8, 2015

Last NPPES UpdateMay 6, 20202 updates tracked since enumeration

NPPES CertifiedMay 6, 2020

✔ NPI 1710367560 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MA · RN2280088

450 BROOKLINE AVE, Boston, MA 02215

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Other Names 1

Former Name (1)Ms. Alexandra Catherine Mulloy Fnp-bc

Other Identifiers 1

Medicaid110105490AMA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Alexandra Catherine Distaso Fnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02215 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$97.64 typical visit price

range $63.72 – $189.86

Typical copayment $24.41 (range $15.93 – $47.46)

Most-billed visit code 99203

Established Patient

$111.18 typical visit price

range $21.07 – $155.29

Typical copayment $27.79 (range $5.26 – $38.82)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RACHEL ANN FREEDMAN M.D.

Internal Medicine

450 BROOKLINE AVE
BOSTON, MA 02215

Suffolk County (617) 632-6973

DR. ROBERT JAMES MAYER MD

Internal Medicine (Medical Oncology)

450 BROOKLINE AVE, DANA FARBER CANCER INSTITUTE, D-1608
BOSTON, MA 02215

Suffolk County (617) 632-3474

DR. JOSEPH O JACOBSON MD

Internal Medicine (Medical Oncology)

450 BROOKLINE AVE, DANA-FARBER CANCER INSTITUTE, D1234
BOSTON, MA 02215

Suffolk County (617) 632-3468

DR. DAVID BARBIE MD

Internal Medicine (Hematology & Oncology)

450 BROOKLINE AVE, DANA 1234
BOSTON, MA 02215

Suffolk County (617) 632-3468

DR. DAVID R D'ADAMO MD

Internal Medicine (Medical Oncology)

450 BROOKLINE AVE
BOSTON, MA 02215

Suffolk County (617) 632-5204

DEBORAH SCHRAG MD

Internal Medicine (Medical Oncology)

450 BROOKLINE AVE
BOSTON, MA 02215

Suffolk County (617) 582-8301

DAVID M WEINSTOCK MD

Internal Medicine (Medical Oncology)

450 BROOKLINE AVE
BOSTON, MA 02215

Suffolk County (617) 632-4245

RANI E GEORGE MD PHD

Pediatrics (Pediatric Hematology-Oncology)

450 BROOKLINE AVE, DANA 322 DEPT OF PEDIATRIC ONCOLOGY
BOSTON, MA 02215

Suffolk County (617) 632-5281

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alexandra Distaso's NPI number?

The NPI number for Alexandra Distaso is 1710367560. It was assigned to this individual provider in the NPPES registry on June 8, 2015. The provider is also known as Ms. Alexandra Catherine Mulloy Fnp-Bc.

Where is Alexandra Distaso located?

Alexandra Distaso practices at 450 Brookline Ave, Boston, MA 02215. The listed phone number is (617) 632-4218.

What is Alexandra Distaso's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Alexandra Distaso enrolled in Medicare?

Yes. Alexandra Distaso is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Alexandra Distaso was last updated on May 6, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.