Judana Sandra Bennett

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN2278761 Issued in MA

Practice address

45 Dimock St
Roxbury, MA 02119-1208

Phone

(617) 816-6505

NPI assigned

Jul 6, 2020

Last updated

Oct 29, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dimock Community Health Center, Inc.Group PAC ID 7012810492, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dimock Community Health Center, Inc

  dba The Dimock Center

  • Federally Qualified Health Center (FQHC)
  • Roxbury, MA
  • NPI 1588719488
  Medicare reassignment Care Compare group NPD
• Bay Cove Human Services, Inc

  • Community/Behavioral Health Agency
  • Boston, MA
  • NPI 1386702264
  Medicare reassignment
• Bay Cove Human Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hyannis, MA
  • NPI 1386355519
  NPD
• Dimock Community Health Center, Inc

  dba Dimock Pharmacy

  • Community/Retail Pharmacy
  • Roxbury, MA
  • NPI 1023850120
  NPD
• Boston Public Health Commission

  dba Asthma Home Visiting & Immunization Prog.

  • Public Health or Welfare Agency
  • Boston, MA
  • NPI 1114201605
  NPD (past)
• Boston Public Health Commission

  dba Behavioral Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • South Boston, MA
  • NPI 1205231941
  NPD (past)

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1073130167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191134",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021190023",
            "telephone_number": "617-442-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 DIMOCK ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191208",
            "telephone_number": "617-816-6505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 James ONeill St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021274504",
            "country_code": "US",
            "telephone_number": "617-534-9500",
            "fax_number": "617-419-1706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23 Bradston St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182703",
            "country_code": "US",
            "telephone_number": "617-318-6484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "JUDANA",
        "middle_name": "SANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2278761",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Monique Beard
• Marissa Bearse, RN
• Alexandria Belcher
• Jasmine Bell
• David Bennett
• Adzele Benoit
• Markarius Bentley
• Douglas Benton
• Anna Berestova
• Berthlyn M Bernier, MSW

• Psychiatric/Mental Health Nurse Practitioner in Roxbury, MA
• Providers in Roxbury, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.