Individual provider Active NPI

Rebecca Ann Delisa, NP

  • Family Nurse Practitioner
  • Springfield, MA
National Provider Identifier
1033196530
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
206128 Issued in MA
Practice address
354 Birnie Ave Ste 202
Springfield, MA 01107-1109
Phone
(413) 733-3470
Fax
(413) 732-4216
NPI assigned
Dec 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 206128 MA Primary

Addresses

Primary practice location

354 Birnie Ave Ste 202
Springfield, MA 01107-1109

Mailing address

354 Birnie Ave Ste 202
Springfield, MA 01107-1109
Phone (413) 733-3470

Other identifiers 1

IdentifierTypeStateIssuer
0376060MedicaidMA

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
206128MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Past Accepting new patients
Hampden County Physician Associates, LLC. Past Accepting new patients
NP Care of Massachusetts LLC Past Accepting new patients
The Mercy Hospital Inc Past Accepting new patients
Hampden County Physician Associates, LLC Past Accepting new patients
Springfield Anesthesia Service, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12089/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1033196530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 BIRNIE AVE STE 202",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071109",
            "telephone_number": "413-733-3470",
            "fax_number": "413-732-4216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 BIRNIE AVE STE 202",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071109",
            "telephone_number": "413-733-3470",
            "fax_number": "413-732-4216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELISA",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-27",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "206128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0376060",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.