Individual provider Active NPI

Rebecca E. Graziano, NP

  • Nurse Practitioner
  • Pembroke, MA
National Provider Identifier
1144207234
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
237465 Issued in MA
Practice address
28 Riverside Dr
Pembroke, MA 02359-1937
Phone
(781) 826-8065
Fax
(781) 826-8043
NPI assigned
Dec 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 237465 MA Primary

Addresses

Primary practice location

28 Riverside Dr
Pembroke, MA 02359-1937

Mailing address

28 Riverside Dr
Pembroke, MA 02359-1937
Phone (781) 826-8065

Other identifiers 1

IdentifierTypeStateIssuer
NP3734OtherMABLUE CROSS BLUE SHIELD

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
I20031122000032 MA Practitioner - Nurse Practitioner 4981508736 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Medical AssociatesGroup PAC ID 7113029257, 443 clinicians

Practice addresses (Care Compare)

55 Fogg Rd
Weymouth, MA 02190-2432
Phone (781) 792-4136

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
237465MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Associates CurrentSince May 10, 2016 Accepting new patients
Martha's Vineyard Hospital Nurse Practitioner Past Accepting new patients

Locations

55 Fogg Rd
#81
Weymouth, MA 02190

55 Fogg Rd
#85
Weymouth, MA 02190

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

Organizations & group practices 3

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 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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1144207234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 RIVERSIDE DR",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "023591937",
            "telephone_number": "781-826-8065",
            "fax_number": "781-826-8043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 RIVERSIDE DR",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "023591937",
            "telephone_number": "781-826-8065",
            "fax_number": "781-826-8043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAZIANO",
        "first_name": "REBECCA",
        "middle_name": "E.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "237465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "NP3734",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke, MA

Sources for this page

Verify at the official NPI Registry.