Individual provider Active NPI

Stacey McEachern, FNP-C

  • Family Nurse Practitioner
  • Hanover, MA
National Provider Identifier
1154790129
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
214670 Issued in MA
Practice address
48 Sunset PT
Hanover, MA 02339-2583
Phone
(781) 864-0391
NPI assigned
Sep 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 214670 MA Primary

Addresses

Primary practice location

48 Sunset PT
Hanover, MA 02339-2583

Mailing address

48 Sunset PT
Hanover, MA 02339-2583

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
I20160418002176 MA Practitioner - Nurse Practitioner 8022316462 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

  • South Shore Hospital Hospital, South Weymouth, MA, CCN 220100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
214670MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Jun 20, 2016 Accepting new patients
Steward Medical Group, Inc CurrentSince Jun 20, 2016 Accepting new patients
Coastal Medical Associates CurrentSince Mar 1, 2021 Accepting new patients

Locations

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

2100 Dorchester Ave
Dorchestr Ctr, MA 02124
Phone (617) 506-2222

141 Longwater Dr
Ste 201
Norwell, MA 02061
Phone (781) 261-7820

800 Washington St
Norwood, MA 02062
Phone (781) 278-6264

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": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1154790129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 SUNSET PT",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "023392583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 SUNSET PT",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "023392583",
            "telephone_number": "781-864-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCEACHERN",
        "first_name": "STACEY",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-21",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "214670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, MA

Sources for this page

Verify at the official NPI Registry.