Individual provider Active NPI

George M Gachuma, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Southbridge, MA
National Provider Identifier
1114425832
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2273574 Issued in MA
Practice address
29 Pine St
Southbridge, MA 01550-1823
Phone
(508) 765-9167
NPI assigned
Jan 28, 2018
Last updated
Nov 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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 RN2273574 MA Primary

Addresses

Primary practice location

29 Pine St
Southbridge, MA 01550-1823

Mailing address

38 Sunny Hill Dr
Worcester, MA 01602-2256

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
I20181016003151 MA Practitioner - Nurse Practitioner 4587916739 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elemental Wellness CenterGroup PAC ID 5991234700, 3 clinicians
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

121 Lincoln St
Worcester, MA 01605-2429
Phone (508) 926-8008

340 Thompson Rd
Webster, MA 01570-1509
Phone (508) 943-5132

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Elemental Wellness Center CurrentSince Dec 1, 2024 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Oct 1, 2023 Accepting new patients
Umass Memorial Health-Harrington Hospital Inc CurrentSince Nov 5, 2018 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Oct 1, 2023 Accepting new patients
George B. Wells Human Services Current Accepting new patients

Locations

100 South St
Southbridge, MA 01550
Phone (508) 764-8012

29 Pine St
Southbridge, MA 01550
Phone (508) 765-2202

10 Winthrop St
Ste 3
Worcester, MA 01604
Phone (774) 321-0665

121 Lincoln St
Worcester, MA 01605
Phone (508) 756-0514

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: georgegachuma@obh.allscriptsdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1517097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1114425832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 SUNNY HILL DR",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016022256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 PINE ST",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015501823",
            "telephone_number": "508-765-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GACHUMA",
        "first_name": "GEORGE",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-28",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2273574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbridge, MA

Sources for this page

Verify at the official NPI Registry.