MEDICARE: BOSTON NORTHWEST HOME CARE INC.

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	163WH0200X	Home Health Registered Nurse
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1134728884
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOSTON NORTHWEST HOME CARE INC.

Provider Business Mailing Address
First Line	:	450 BEDFORD ST STE 2200
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02420-1515
Country	:	US
Telephone Number	:	781-315-6700
Fax Number	:	781-385-4606

Provider Business Practice Location Address
First Line	:	450 BEDFORD ST STE 2200
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02420-1515
Country	:	US
Telephone Number	:	781-315-6700
Fax Number	:	781-385-4606

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID TASTO
Credential	:
Telephone Number	:	781-315-6700

Provider Enumeration Date	:	10/23/2020
Last Update Date	:	02/02/2026

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