Individual provider Active NPI

Rachel M Preiss, RN, NP

  • Nurse Practitioner
  • Roxbury, MA
National Provider Identifier
1134379753
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
248057 Issued in MA
Practice address
45 Dimock St
Roxbury, MA 02119-1208
Phone
(617) 442-4088
NPI assigned
Sep 19, 2008
Last updated
Mar 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 060109-23 NH
Nurse Practitioner 363L00000X 248057 MA Primary
Registered Nurse 163W00000X 060109-21 NH
Registered Nurse 163W00000X 278057 MA

Addresses

Primary practice location

45 Dimock St
Roxbury, MA 02119-1208

Mailing address

55 Dimock St
Roxbury, MA 02119-1029
Phone (617) 442-8800

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
I20160225002485 MA Practitioner - Nurse Practitioner 9739231747 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
060109-21NHMDRegistered Nurse
278057MAMDFamily Medicine Physician
060109-23NHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dimock Community Health Center, Inc CurrentSince Dec 26, 2015 Accepting new patients
Dimock Community Health Center, Inc CurrentSince Dec 26, 2015 Accepting new patients

Locations

45 Dimock St
Roxbury, MA 02119

45 Dimock St
Fl 1
Roxbury, MA 02119

55 Dimock St
Roxbury, MA 02119

Interoperability endpoints

  • Direct secure messaging: rachel.preiss@tdc.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1134379753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 DIMOCK ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191029",
            "telephone_number": "617-442-8800",
            "fax_number": "617-442-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 DIMOCK ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191208",
            "telephone_number": "617-442-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREISS",
        "first_name": "RACHEL",
        "middle_name": "M",
        "credential": "RN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-19",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NH",
            "license": "060109-23",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "248057",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NH",
            "license": "060109-21",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "278057",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

Verify at the official NPI Registry.