Individual provider Active NPI

Marie C Victor

  • Family Nurse Practitioner
  • Holyoke, MA
National Provider Identifier
1003307596
Registry record updated Apr 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2337712 Issued in MA
Practice address
2 Hospital Dr Ste 101
Holyoke, MA 01040-6616
Phone
(413) 536-8924
NPI assigned
May 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9267015 FL
Family Nurse Practitioner 363LF0000X RN2337712 MA Primary

Addresses

Primary practice location

2 Hospital Dr Ste 101
Holyoke, MA 01040-6616

Mailing address

2823 SW 82ND Ave
Miramar, FL 33025-7404
Phone (954) 638-0324

Other practice location 1

2823 SW 82nd Ave
Miramar, FL 33025-7404
Phone (954) 638-0324

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200417001653 MA Practitioner - Nurse Practitioner 4688004443 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9267015FLMDFamily Nurse Practitioner
RN2337712MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Western Mass Physician Associates Inc CurrentSince Mar 16, 2020 Accepting new patients
Western Mass Physician Associates Inc CurrentSince Mar 16, 2020 Accepting new patients

Locations

262 New Ludlow Rd
Chicopee, MA 01020
Phone (413) 535-4714

10 Hospital Dr
Ste 306
Holyoke, MA 01040
Phone (413) 539-6830

2 Hospital Dr
Ste 101
Holyoke, MA 01040
Phone (413) 536-6902

15 Hospital Dr
Ste 50
Holyoke, MA 01040
Phone (413) 534-2826

140 Southampton Rd
Westfield, MA 01085
Phone (413) 533-2452

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1003307596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 SW 82ND AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330257404",
            "telephone_number": "954-638-0324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 HOSPITAL DR STE 101",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010406616",
            "telephone_number": "413-536-8924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2823 SW 82nd Ave",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330257404",
            "country_code": "US",
            "telephone_number": "954-638-0324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VICTOR",
        "first_name": "MARIE",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-21",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9267015",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2337712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holyoke, MA

Sources for this page

Verify at the official NPI Registry.