Active NPI
Omayra Nieves
- Psychosomatic Medicine Physician
- Cambridge, MA
National Provider Identifier
1003848037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychosomatic Medicine Physician
- License
- 221002
- Practice address
- 30 Cambridgepark Dr Apt 6115
Cambridge, MA 02140-2383 - Phone
- (617) 877-5797
- NPI assigned
- Jul 7, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychosomatic Medicine Physician | 2084P0015X | 221002 | MA | Primary |
Addresses
Primary practice location
30 Cambridgepark Dr Apt 6115
Cambridge, MA 02140-2383
Mailing address
30 Cambridgepark Dr Apt 6115
Cambridge, MA 02140-2383
Phone (617) 877-5797
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 221002 | MA | MD | Psychosomatic Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Psychiatric Planners, Inc | Current | Accepting new patients | |
| Administrators of the Tulane Education Fund | Past | Accepting new patients | |
| Administrators of the Tulane Educational Fund | Past | Accepting new patients | |
| Cambridge Public Health Commission | Past | Accepting new patients |
Locations
300 South St
Chestnut Hill, MA 02467
Phone (617) 469-0300
Organizations & group practices 4
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.
-
- Psychiatric Hospital
- Brookline, MA
- NPI 1093714412
-
- General Acute Care Hospital
- Cambridge, MA
- NPI 1487603585
-
- Anatomic Pathology & Clinical Pathology Physician
- New Orleans, LA
- NPI 1790354595
-
- Specialist
- New Orleans, LA
- NPI 1528014164
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712880000000",
"number": "1003848037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 CAMBRIDGEPARK DR APT 6115",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021402383",
"telephone_number": "617-877-5797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 CAMBRIDGEPARK DR APT 6115",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021402383",
"telephone_number": "617-877-5797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIEVES",
"first_name": "OMAYRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-07",
"last_updated": "2024-04-12",
"certification_date": "2024-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0015X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychosomatic Medicine",
"state": "MA",
"license": "221002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.