Individual provider Active NPI

Samantha Williams, FNP-BC

  • Family Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1003571209
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2291233 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(508) 421-1400
Fax
(508) 421-1490
NPI assigned
Nov 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X RN2291233 MA
Nurse Practitioner 363L00000X RN2291233 MA
Family Nurse Practitioner 363LF0000X RN2291233 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348

Other practice location 1

830 Constitution Ave
Littleton, MA 01460-1137
Phone (978) 287-8990

Other practice location 2

41 Mall Rd
Burlington, MA 01805-0002
Phone (781) 744-8000

Other practice location 3

20 Commercial Rd
Leominster, MA 01453-3339
Phone (978) 798-6896

Other identifiers 1

IdentifierTypeStateIssuer
110181284AMedicaidMA

Other names 1

  • Samantha Rogers Former name

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
I20211207000364 MA Practitioner - Nurse Practitioner 5092105098 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2291233MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Convenientmd - FFS UC LLC CurrentSince Oct 7, 2023 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Oct 7, 2023 Accepting new patients
Convenientmd - FFS UC LLC Current Accepting new patients
Convenientmd - FFS UC LLC Past Accepting new patients
Convenientmd LLC Past Accepting new patients
Convenientmd LLC Past Accepting new patients

Locations

245 Hartford Ave
Bellingham, MA 02019
Phone (774) 295-4355

40 Davis Straits
Falmouth, MA 02540
Phone (774) 255-3010

20 Commercial Rd
Ste 2
Leominster, MA 01453
Phone (978) 798-6896

111 New Hampshire Ave
Portsmouth, NH 03801

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

Interoperability endpoints

  • Direct secure messaging: swilliams191809@direct.bilh.masshiway.net

Organizations & group practices 8

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": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1003571209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-421-1400",
            "fax_number": "508-421-1490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 Constitution Ave",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "MA",
            "postal_code": "014601137",
            "country_code": "US",
            "telephone_number": "978-287-8990",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018050002",
            "country_code": "US",
            "telephone_number": "781-744-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 Commercial Rd",
            "address_purpose": "LOCATION",
            "city": "Leominster",
            "state": "MA",
            "postal_code": "014533339",
            "country_code": "US",
            "telephone_number": "978-798-6896",
            "fax_number": "978-798-6897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SAMANTHA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-02",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "MA",
            "license": "RN2291233",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2291233",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2291233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110181284A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "ROGERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.