Elaine M Allendorf, NP | NPI 1104944115

Key facts

NPI: 1104944115
Entity type: Individual (NPI type 1)
Primary specialty: Occupational Health Nurse Practitioner 363LX0106X
License: 118172 (MA)
Practice address: 363 Highland Ave
Fall River, MA 02720-3703
Phone: (508) 973-7044
Fax: (508) 973-7667
NPI assigned: Mar 27, 2007
Sex: Female
Sole proprietor: No

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.

Southcoast Physicians Group, Inc. Family Medicine Physician · Fairhaven, MA · NPI 1336137629

Medicare reassignment NPD MA
Southcoast Physicians Group, Inc. Orthopaedic Surgery Physician · North Dartmouth, MA · NPI 1902201536

NPD

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MA
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20121126000480	MA	Practitioner - Nurse Practitioner	6507017407	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Nurse Practitioner

State licenses

License	State	Type	Specialty
118172	MA	MD	Occupational Health Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
Southcoast Physicians Group, Inc.		Current since Oct 1, 2012	Accepting new patients
Southcoast Physicians Group, Inc.		Current since Oct 1, 2012	Accepting new patients

Locations

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

1030 President Ave
Ste 107
Fall River, MA 02720
Phone (508) 676-3411

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Occupational Health Nurse Practitioner	363LX0106X	118172	MA	Yes

Addresses

Primary practice location

363 Highland Ave
Fall River, MA 02720-3703

Mailing address

200 Mill Rd
Suite 180
Fairhaven, MA 02719-5252
Phone (508) 973-2000

Electronic endpoints

Type	Endpoint	Use	Affiliation
Direct Messaging Address	eallendorf19790@direct.southcoast.org

Other providers in Fall River, MA

All providers in Fall River, MA · Occupational Health Nurse Practitioner in Massachusetts

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.