Individual provider Active NPI

Alice J. Vaine, N.P.C.

  • Family Nurse Practitioner
  • Gardner, MA
National Provider Identifier
1164418059
Registry record updated Jan 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
165352 Issued in MA
Practice address
242 Green St
Dept. of Surgery
Gardner, MA 01440-1336
Phone
(978) 630-6267
Fax
(978) 630-6596
NPI assigned
Sep 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 165352 MA Primary
Emergency Clinical Nurse Specialist 364SE0003X 165352 MA

Addresses

Primary practice location

242 Green St
Dept. of Surgery
Gardner, MA 01440-1336

Mailing address

242 Green St
Dept. of Surgery
Gardner, MA 01440-1336
Phone (978) 630-6267

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
I20031122000072 MA Practitioner - Nurse Practitioner 9032013883 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Heywood Medical Group Inc.Group PAC ID 6901882836, 111 clinicians

Practice addresses (Care Compare)

165 Mill St
Leominster, MA 01453-3289
Phone (978) 878-8100

2033 Main St
Athol, MA 01331-3535
Phone (978) 249-3511

250 Green St
Gardner, MA 01440-1396
Phone (978) 630-6460

81 Reservoir Dr
Athol, MA 01331-4901
Phone (978) 248-5135

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
165352MAMDEmergency Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Heywood Memorial Hospital Family CurrentSince Oct 16, 2003 Accepting new patients
Athol Memorial Hospital Incorporated Family CurrentSince Apr 20, 2018 Accepting new patients
Community Health Connections, Inc. Current Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Oct 16, 2003 Accepting new patients
Community Health Connections, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Heywood Medical Group Inc. Family CurrentSince Aug 1, 2003 Accepting new patients
Community Health Connections, Inc. CurrentSince Aug 1, 2024 Accepting new patients

Locations

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

81 Reservoir Dr
#A
Athol, MA 01331

81 Reservoir Dr
Side
Athol, MA 01331

130 Water St
Ste 4
Fitchburg, MA 01420
Phone (978) 868-9944

326 Nichols Rd
Fitchburg, MA 01420
Phone (978) 343-5270

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

529 Timpany Blvd
Gardner, MA 01440
Phone (978) 400-3031

250 Green St
Gardner, MA 01440
Phone (978) 630-5050

175 Connors St
Gardner, MA 01440
Phone (978) 410-6100

242 Green St
Ste 205
Gardner, MA 01440

14 Manning Ave
Leominster, MA 01453
Phone (978) 847-0110

165 Mill St
Leominster, MA 01453
Phone (978) 466-3208

Interoperability endpoints

  • Direct secure messaging: alice.vaine.1@192.direct.athenahealth.com

Organizations & group practices 7

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": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264032000000",
    "number": "1164418059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "address_2": "DEPT. OF SURGERY",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401336",
            "telephone_number": "978-630-6267",
            "fax_number": "978-630-6596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "address_2": "DEPT. OF SURGERY",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401336",
            "telephone_number": "978-630-6267",
            "fax_number": "978-630-6596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAINE",
        "first_name": "ALICE",
        "middle_name": "J.",
        "credential": "N.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2010-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "165352",
            "primary": true
        },
        {
            "code": "364SE0003X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Emergency",
            "state": "MA",
            "license": "165352",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardner, MA

Sources for this page

Verify at the official NPI Registry.