Individual provider Active NPI

Chrystina Maria Soloperto, CNP

  • Nurse Practitioner
  • Auburn, MA
National Provider Identifier
1043695141
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2261126 Issued in MA
Practice address
105 Millbury St
Auburn, MA 01501-3204
Phone
(508) 832-9691
Fax
(508) 832-7670
NPI assigned
Jul 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2261126 MA Primary

Addresses

Primary practice location

105 Millbury St
Auburn, MA 01501-3204

Mailing address

105 Millbury St
Auburn, MA 01501-3205
Phone (508) 835-9692

Other practice location 1

55 Lake Ave N
Worcester, MA 01655-0002
Phone (774) 441-8081

Other names 1

  • Chrystina Maria Manero Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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
I20220222002456 MA Practitioner - Nurse Practitioner 6305230087 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2261126MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Nurse Practitioner CurrentSince Feb 10, 2022 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Feb 10, 2022 Accepting new patients

Locations

604 Main St
Shrewsbury, MA 01545
Phone (508) 842-0057

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: chrystina.manero.1@20124.direct.athenahealth.com

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1043695141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MILLBURY ST",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015013205",
            "telephone_number": "508-835-9692",
            "fax_number": "508-832-7670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MILLBURY ST",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015013204",
            "telephone_number": "508-832-9691",
            "fax_number": "508-832-7670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "774-441-8081",
            "fax_number": "774-441-8055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLOPERTO",
        "first_name": "CHRYSTINA",
        "middle_name": "MARIA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-30",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2261126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHRYSTINA",
            "last_name": "MANERO",
            "middle_name": "MARIA",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Auburn, MA

Sources for this page

Verify at the official NPI Registry.