Individual provider Active NPI

Ashley Marie Graveline, FNP-BC

  • Family Nurse Practitioner
  • Springfield, MA
National Provider Identifier
1003591900
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2266468 Issued in MA
Practice address
300 Stafford St
Springfield, MA 01104-4110
Phone
(413) 748-7095
Fax
(413) 732-0225
NPI assigned
Jun 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2266468 MA
Family Nurse Practitioner 363LF0000X RN2266468 MA Primary

Addresses

Primary practice location

300 Stafford St
Springfield, MA 01104-4110

Mailing address

2 Medical Center Dr Ste 410
Springfield, MA 01107-1273
Phone (413) 748-7095

Other names 1

  • Ashley Marie Brodeur 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
I20231026003538 MA Practitioner - Nurse Practitioner 7719333780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pioneer Valley Cardiology Associates, IncGroup PAC ID 7618128794, 24 clinicians

Practice addresses (Care Compare)

2 Medical Ctr Dr
Suite 410
Springfield, MA 01107-1273
Phone (413) 748-7095

Hospital & facility affiliations

  • Mercy Medical Ctr Hospital, Springfield, MA, CCN 220066
  • Baystate Medical Center Hospital, Springfield, MA, CCN 220077

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pioneer Valley Cardiology Associates, Inc CurrentSince Oct 6, 2023 Accepting new patients
Pioneer Valley Cardiology Associates ,Inc. CurrentSince Oct 6, 2023 Accepting new patients

Locations

2 Medical Center Dr
Ste 410
Springfield, MA 01107
Phone (413) 781-5735

300 Stafford St
Springfield, MA 01104
Phone (413) 737-1600

300 Stafford St
Ste 154
Springfield, MA 01104
Phone (413) 748-7095

300 Stafford St
Ste 101
Springfield, MA 01104
Phone (413) 732-1928

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: agraveline2384493@direct.trinity-health.org

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.

Hospital & facility affiliations 4

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": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1003591900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MEDICAL CENTER DR STE 410",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071273",
            "telephone_number": "413-748-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STAFFORD ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011044110",
            "telephone_number": "413-748-7095",
            "fax_number": "413-732-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVELINE",
        "first_name": "ASHLEY",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2266468",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2266468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "BRODEUR",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.