Individual provider Active NPI

Grace Mbuya, PMHNP

  • Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1104225341
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN284646 Issued in MA
Practice address
120 Stafford St
Worcester, MA 01603-1457
Phone
(508) 344-7530
NPI assigned
Aug 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 284646 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN284646 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 316951 AZ
Nurse Practitioner 363L00000X RN284646 MA Primary

Addresses

Primary practice location

120 Stafford St
Worcester, MA 01603-1457

Mailing address

21 SW Cutoff
Northborough, MA 01532-2135
Phone (508) 344-7530

Other practice location 1

15333 N Pima Rd
Scottsdale, AZ 85260-2783
Phone (508) 344-7530

Other practice location 2

21 SW Cutoff
Northborough, MA 01532-2135
Phone (508) 344-7530

Other identifiers 1

IdentifierTypeStateIssuer
PIDSL110186617AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201116001004 MA Practitioner - Nurse Practitioner 1456770551 Reassigns benefits to 2 organizations
I20250515002685 AZ Practitioner - Nurse Practitioner 1456770551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mind Healing and Wellness CenterGroup PAC ID 8224576327, 4 clinicians

Practice addresses (Care Compare)

Scottsdale, AZ 85260
Phone (508) 344-7530

120 Stafford St
Worcester, MA 01603-1457

21 SW Cutoff
Northborough, MA 01532-2135
Phone (508) 344-7530

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
284646MAMDPsychiatric/Mental Health Registered Nurse
316951AZMDPsychiatric/Mental Health Nurse Practitioner
RN284646MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Healing & Wellness Center CurrentSince Jul 1, 2024 Accepting new patients
Community Health Connections, Inc. CurrentSince Jan 1, 2021 Accepting new patients
Community Health Connections, Inc. CurrentSince Jan 1, 2021 Accepting new patients
Community Health Connections, Inc. Current Accepting new patients

Locations

890 W Elliot Rd
Fl 1
Gilbert, AZ 85233
Phone (508) 344-7530

15333 N Pima Rd
Ste 305
Scottsdale, AZ 85260
Phone (480) 225-3236

326 Nichols Rd
Fitchburg, MA 01420
Phone (978) 343-5270

175 Connors St
Gardner, MA 01440
Phone (978) 410-6100

14 Manning Ave
Leominster, MA 01453
Phone (978) 847-0110

21 SW Cutoff
Northborough, MA 01532
Phone (508) 344-7530

120 Stafford St
Worcester, MA 01603
Phone (508) 344-7530

Interoperability endpoints

  • Direct secure messaging: grace.mbuya.p1@direct.chcfhc.nextgenshare.com

Organizations & group practices 4

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": "1407888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1104225341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 SW CUTOFF",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015322135",
            "telephone_number": "508-344-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 STAFFORD ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016031457",
            "telephone_number": "508-344-7530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15333 N Pima Rd",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852602783",
            "country_code": "US",
            "telephone_number": "508-344-7530",
            "fax_number": "508-466-8282",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21 SW Cutoff",
            "address_purpose": "LOCATION",
            "city": "Northborough",
            "state": "MA",
            "postal_code": "015322135",
            "country_code": "US",
            "telephone_number": "508-344-7530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MBUYA",
        "first_name": "GRACE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-13",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MA",
            "license": "284646",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN284646",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "316951",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN284646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PIDSL110186617A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.