Kimberly Beth Abdow, N.P.
Individual provider Active NPI Psychiatric/Mental Health Registered Nurse · Worcester, MA
NPI 1003007477 · NPPES record last updated Jan 23, 2019
Key facts
- NPI
- 1003007477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Registered Nurse 163WP0808X
- License
- RN206918 (MA)
- Practice address
- 435 Shrewsbury St
Worcester, MA 01609-2265 - Phone
- (508) 753-5554
- Fax
- (508) 752-7245
- NPI assigned
- Aug 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Behavioral Healthcare Services
Practice addresses (Care Compare)
435 Shrewsbury St
Worcester, MA 01604-1689
Phone 5087535554110
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071010000494 | MA | Practitioner - Nurse Practitioner | 2567558349 |
Reassigns benefits to 1 organization Practice locations: Worcester, MA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN206918 | MA | MD | Psychiatric/Mental Health Registered Nurse |
| 206917 | MA | MD | Family Health Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Healthcare Services | Current |
Accepting new patients |
Locations
435 Shrewsbury St
Worcester, MA 01604
Phone (508) 577-2017
Interoperability endpoints
- https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/R4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Health Clinical Nurse Specialist | 364SF0001X | 206917 | MA | |
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | RN206918 | MA | Yes |
Addresses
Primary practice location
435 Shrewsbury St
Worcester, MA 01609-2265
Mailing address
202 Russell St
Worcester, MA 01609-2265
Phone (508) 753-5554
Other providers in Worcester, MA
- Sharif Ali Abdel Jalil
- Amal Abdelgadir
- Ayman Abdelgadir
- Israh Yousef Abdeljaber
- Houda Abdelrahman
- Elisa Abdulhayoglu
- Bassma Abdulky
- Faiza Mohammed Abdulla
- Ibrahim Abdulmassih
- Luqman Abdur-Rauf
All providers in Worcester, MA · Psychiatric/Mental Health Registered Nurse in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.