Individual provider Active NPI

Stefania M Peralta, RN

  • Registered Nurse
  • Worcester, MA
National Provider Identifier
1003371634
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN2328799 Issued in MA
Practice address
19 Tacoma St
Worcester, MA 01605-3516
Phone
(508) 852-1805
NPI assigned
Feb 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2328799 MA Primary

Addresses

Primary practice location

19 Tacoma St
Worcester, MA 01605-3516

Mailing address

34 Shrewsbury Green Dr Unit J
Shrewsbury, MA 01545-3636
Phone (617) 763-8292

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
I20211015001579 MA Practitioner - Nurse Practitioner 7911305305 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Massachusetts Medical School, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

5 Neponset St
Worcesteer, MA 01606-2714
Phone (508) 595-2300

Hospital & facility affiliations

  • St Vincent Hospital Hospital, Worcester, MA, CCN 220176

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN2328799MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Sep 15, 2021 Accepting new patients
Reliant Medical Group, Inc CurrentSince May 5, 2025 Accepting new patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Sep 15, 2021 Accepting new patients
Edward M. Kennedy Community Health Center, Inc Past Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

354 Waverley St
Framingham, MA 01702
Phone (508) 270-5700

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

5 Neponset St
#12
Worcester, MA 01606
Phone (508) 595-2300

650 Lincoln St
Worcester, MA 01605
Phone (508) 532-7318

19 Tacoma St
Worcester, MA 01605
Phone (508) 854-2122

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1549497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1003371634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 SHREWSBURY GREEN DR UNIT J",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "015453636",
            "telephone_number": "617-763-8292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 TACOMA ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053516",
            "telephone_number": "508-852-1805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERALTA",
        "first_name": "STEFANIA",
        "middle_name": "M",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-07",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2328799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.