Individual provider Active NPI

Fatima Medeiros

  • Nurse Practitioner
  • Fall River, MA
National Provider Identifier
1144757998
Registry record updated Sep 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2264174 Issued in MA
Practice address
534 Prospect St
Fall River, MA 02720-5281
Phone
(508) 973-7766
Fax
(508) 973-7753
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN02392 RI
Nurse Practitioner 363L00000X RN2264174 MA Primary

Addresses

Primary practice location

534 Prospect St
Fall River, MA 02720-5281

Mailing address

200 Mill Rd Ste 2180
Fairhaven, MA 02719-5252
Phone (508) 973-2000

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
I20170802003220 MA Practitioner - Nurse Practitioner 1557632916 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

534 Prospect St
Fall River, MA 02720-5281
Phone (508) 973-7766

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2264174MAMDNurse Practitioner
APRN02392RIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prima Care, PC CurrentSince Jul 1, 2017 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince May 1, 2021 Accepting new patients
Prima Care, PC CurrentSince Jul 1, 2017 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince May 1, 2021 Accepting new patients

Locations

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

289 Pleasant St
Fall River, MA 02721
Phone (508) 674-7779

67 Slades Ferry Ave
Somerset, MA 02726
Phone (508) 673-9400

Interoperability endpoints

  • Direct secure messaging: fmedeiros27270@direct.southcoast.org

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 4

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725148800000",
    "number": "1144757998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD STE 2180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195252",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 PROSPECT ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027205281",
            "telephone_number": "508-973-7766",
            "fax_number": "508-973-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDEIROS",
        "first_name": "FATIMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2024-09-01",
        "certification_date": "2024-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN02392",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2264174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.