Individual provider Active NPI

Omayra Nieves

  • Psychosomatic Medicine Physician
  • Cambridge, MA
National Provider Identifier
1003848037
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychosomatic Medicine PhysicianTaxonomy code 2084P0015X
License
221002 Issued in MA
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

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
221002MAMDPsychosomatic Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Psychiatric Planners, Inc CurrentSince Dec 1, 2014 Accepting new patients
Administrators of the Tulane Education Fund PastSince Jul 31, 2023 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.

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.

Verify at the official NPI Registry.