MEDICARE: BEVERLY ONG FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	2355165	MA
2	363LP2300X	Primary Care Nurse Practitioner	1356232896	MA

General Provider Information

NPI Number	:	1356232896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEVERLY ONG FNP-BC

Provider Business Mailing Address
First Line	:	50 ELDRED ST
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02420-1430
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 ELDRED ST
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02420-1430
Country	:	US
Telephone Number	:	339-927-2565
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2025
Last Update Date	:	05/21/2026

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Directions to “ BEVERLY ONG FNP-BC” Practice Location

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