Organization Active NPI

Worcester Physicians and Nurses Services LLC

  • Internal Medicine Physician
  • Worcester, MA
National Provider Identifier
1164993291
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WORCESTER PHYSICIANS AND NURSES SERVICES LLC
Practice address
111 Elm St Ste 201
Worcester, MA 01609-1967
Phone
(508) 556-1072
NPI assigned
Dec 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

Name
Lynn Gervais
Title
Practice Manager
Phone
(508) 556-1072

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

111 Elm St Ste 201
Worcester, MA 01609-1967

Mailing address

111 Elm St Ste 201
Worcester, MA 01609-1967
Phone (508) 556-1072

Other names 1

  • WPNS Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190411000759 MA Part B Supplier - Clinic/Group Practice 3375884703 Receives reassigned benefits from 4 practitioners
Practice locations: Worcester, MA

National Provider Directory

National Provider Directory

Locations

39 Queen St
Fl 4
Worcester, MA 01610
Phone (508) 556-1072

111 Elm St
Ste 210
Worcester, MA 01609

111 Elm St
Worcester, MA 01609
Phone (508) 756-3750

111 Elm St
Ste 201
Worcester, MA 01609
Phone (508) 556-1072

39 Queen St
Worcester, MA 01610
Phone (508) 481-6123

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1164993291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ELM ST STE 201",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091967",
            "telephone_number": "508-556-1072",
            "fax_number": "508-318-8037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ELM ST STE 201",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091967",
            "telephone_number": "508-556-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WORCESTER PHYSICIANS AND NURSES SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "GERVAIS",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "508-556-1072"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WPNS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.