Individual provider Active NPI

Beth H Dombrowski, N.P.

  • Family Nurse Practitioner
  • Mansfield, MA
National Provider Identifier
1124448428
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2284354 Issued in MA
Practice address
200 Copeland Dr
Mansfield, MA 02048-1225
Phone
(508) 339-4144
NPI assigned
Apr 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2284354 MA
Family Nurse Practitioner 363LF0000X RN2284354 MA Primary

Addresses

Primary practice location

200 Copeland Dr
Mansfield, MA 02048-1225

Mailing address

200 Copeland Dr
Mansfield, MA 02048-1225
Phone (508) 339-4144

Other identifiers 1

IdentifierTypeStateIssuer
S400251735OtherMAMEDICARE PTAN

Other names 1

  • Beth A Hurlburt Former name

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
I20151023000414 MA Practitioner - Nurse Practitioner 2062587611 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sturdy Health IncGroup PAC ID 9537152806, 191 clinicians

Practice addresses (Care Compare)

200 Copeland Dr
Mansfield, MA 02048-1225
Phone (508) 339-4144

60 Messenger St
Plainville, MA 02762-2258
Phone (508) 695-0055

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Wakefield, MA, CCN 227211
  • Accentcare Home Health of Massachusetts Home health agency, Fall River, MA, CCN 227203
  • Sturdy Memorial Hospital Hospital, Attleboro, MA, CCN 220008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2284354MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Sturdy Memorial Hospital Inc CurrentSince Feb 11, 2015 Accepting new patients
Sturdy Health Inc CurrentSince Mar 27, 2018 Accepting new patients
Sturdy Health Inc Past Accepting new patients

Locations

200 Copeland Dr
Mansfield, MA 02048
Phone (508) 339-4144

60 Messenger St
Plainville, MA 02762
Phone (508) 695-0055

211 Park St
South Attleboro, MA 02703
Phone (508) 222-5200

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.

Hospital & facility affiliations 3

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": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1124448428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 COPELAND DR",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020481225",
            "telephone_number": "508-339-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 COPELAND DR",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020481225",
            "telephone_number": "508-339-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMBROWSKI",
        "first_name": "BETH",
        "middle_name": "H",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-24",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2284354",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2284354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "S400251735",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETH",
            "last_name": "HURLBURT",
            "middle_name": "A",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mansfield, MA

Sources for this page

Verify at the official NPI Registry.