Individual provider Active NPI

Olena Dreyfus, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Salem, MA
National Provider Identifier
1063130656
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2318303 Issued in MA
Practice address
100 Highland Ave
Salem, MA 01970-2702
Phone
(781) 244-0115
NPI assigned
Aug 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2318303 MA Primary

Addresses

Primary practice location

100 Highland Ave
Salem, MA 01970-2702

Mailing address

100 Highland Ave
Salem, MA 01970-2702
Phone (781) 244-0115

Other practice location 1

52 Oak St
Middleboro, MA 02346-2078
Phone (508) 923-5300

Other practice location 2

55 Fogg Rd
Weymouth, MA 02190-2432
Phone (781) 624-8000

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
I20221014001985 MA Practitioner - Nurse Practitioner 9931575081 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2318303MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The McLean Hospital Corporation CurrentSince Oct 1, 2022 Accepting new patients
Alta Mental Health LLC Psychiatric/Mental Health CurrentSince Sep 1, 2022 Accepting new patients
Coastal Medical Associates CurrentSince Feb 27, 2025 Accepting new patients

Locations

115 Mill St
Belmont, MA 02478
Phone (617) 855-2000

23 Isaac St
Middleboro, MA 02346
Phone (774) 419-1000

52 Oak St
Middleboro, MA 02346
Phone (508) 923-5300

100 Highland Ave
Salem, MA 01970
Phone (978) 744-8686

100 Highland Ave
Ste 204
Salem, MA 01970
Phone (781) 244-0115

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

Organizations & group practices 3

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": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1063130656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HIGHLAND AVE",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702702",
            "telephone_number": "781-244-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGHLAND AVE",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702702",
            "telephone_number": "781-244-0115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "52 Oak St",
            "address_purpose": "LOCATION",
            "city": "Middleboro",
            "state": "MA",
            "postal_code": "023462078",
            "country_code": "US",
            "telephone_number": "508-923-5300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Fogg Rd",
            "address_purpose": "LOCATION",
            "city": "Weymouth",
            "state": "MA",
            "postal_code": "021902432",
            "country_code": "US",
            "telephone_number": "781-624-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DREYFUS",
        "first_name": "OLENA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-19",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2318303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

Verify at the official NPI Registry.