Sophia Khalifa
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Devens, MA
NPI 1013794544 · NPPES record last updated Sep 8, 2023
Key facts
- NPI
- 1013794544
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- RN2311715 (MA)
- Practice address
- 85 Patton Rd
Devens, MA 01434-4401 - Phone
- (978) 615-5200
- NPI assigned
- Sep 8, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Massachusetts Medical School, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Northeast Health Services LLC
Devens Treatment and Recovery Center LLC
Practice addresses (Care Compare)
59 Lowes Way
Lowell, MA 01851-5018
Phone (978) 565-0569
85 Patton Rd
Devens, MA 01434-4401
Phone (978) 615-5200
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240501002865 | MA | Practitioner - Nurse Practitioner | 2062852593 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2311715 | MA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Health Services, LLC | Current |
Accepting new patients | |
| Devens Treatment & Recovery Center, LLC | Psychiatric/Mental Health | Current |
Accepting new patients |
| Devens Treatment & Recovery Center, LLC | Past | Accepting new patients |
Locations
19 Midstate Dr
Ste 110
Auburn, MA 01501
85 Patton Rd
Devens, MA 01434
Phone (978) 615-5200
59 Lowes Way
Lowell, MA 01851
Phone (617) 733-4166
30 Taunton Grn
Ste 5
Taunton, MA 02780
Phone (508) 545-7400
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | RN2311715 | MA | Yes |
Addresses
Primary practice location
85 Patton Rd
Devens, MA 01434-4401
Mailing address
5 Webber Rd
Burlington, MA 01803-2838
Phone (617) 771-8718
Other providers in Devens, MA
- Eric Stuart Hall
- Lynette J Harvey
- Kristen Ann Hickey
- Robert Kalugo
- Manpreet Kaur
- Victoria Kisakye
- Jean-Merimee Kouagheu
- Rebecca Lanteigne
- Ethan Lindenbaum
- Julie M Macwilliams
All providers in Devens, MA · Psychiatric/Mental Health Nurse Practitioner in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.