Individual provider Active NPI

Stefania Cunningham, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1083353338
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2273854 Issued in MA
Practice address
585 Lincoln St
Worcester, MA 01605-1906
Phone
(774) 670-4520
NPI assigned
Jun 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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 RN2273854 MA Primary

Addresses

Primary practice location

585 Lincoln St
Worcester, MA 01605-1906

Mailing address

1120 Commercial St
Weymouth, MA 02189-1632
Phone (781) 258-4861

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
I20221019001893 MA Practitioner - Nurse Practitioner 8729454517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Spectrum Health Systems, IncGroup PAC ID 8224017082, 16 clinicians

Practice addresses (Care Compare)

585 Lincoln St
Worcester, MA 01605-1906
Phone (508) 831-0045

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2273854MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Systems Inc CurrentSince Jan 23, 2023 Accepting new patients
Spectrum Health Systems, Inc CurrentSince Jan 23, 2023 Accepting new patients

Locations

149 Oak St
Westborough, MA 01581

178 Winter St
Weymouth, MA 02188
Phone (781) 331-0690

585 Lincoln St
Worcester, MA 01605
Phone (508) 831-0045

10 Mechanic St
Ste 302
Worcester, MA 01608
Phone (508) 792-5400

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": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1083353338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 COMMERCIAL ST",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021891632",
            "telephone_number": "781-258-4861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 LINCOLN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016051906",
            "telephone_number": "774-670-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "STEFANIA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-02",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2273854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.