Individual provider Active NPI

Nathan Samuels, NP

  • Adult Health Nurse Practitioner
  • Beverly, MA
National Provider Identifier
1184638629
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NP258431 Issued in MA
Practice address
77 Herrick St
Ste 101
Beverly, MA 01915-3012
Phone
(978) 927-4110
Fax
(978) 232-7057
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NP258431 MA Primary

Addresses

Primary practice location

77 Herrick St
Ste 101
Beverly, MA 01915-3012

Mailing address

77 Herrick St
Ste 101
Beverly, MA 01915-3012
Phone (978) 927-4110

Other identifiers 1

IdentifierTypeStateIssuer
NP9661OtherMABS

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
I20060106000344 MA Practitioner - Nurse Practitioner 6608899547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

100 2ND Ave
Needham, MA 02494-2809
Phone (781) 726-4800

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

228 Billerica Rd
Chelmsford, MA 01824-3604
Phone (978) 250-6000

291 Independence Dr
Chestnut Hill, MA 02467-3628
Phone (617) 325-2800

77 Herrick St
Suite 101
Beverly, MA 01915-2734
Phone (978) 927-4110

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP258431MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Current Accepting new patients
Atrius Health, Inc. CurrentSince Jun 1, 2012 Accepting new patients
Atrius Health, Inc. Past Accepting new patients
Medical Group, Inc., the Past Accepting new patients

Locations

77 Herrick St
Ste 101
Beverly, MA 01915
Phone (978) 232-7115

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
#9
Boston, MA 02109
Phone (617) 859-5170

Interoperability endpoints

  • Direct secure messaging: nsamuels46342@direct.atrius.masshiway.net

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 5

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184638629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 HERRICK ST",
            "address_2": "STE 101",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019153012",
            "telephone_number": "978-927-4110",
            "fax_number": "978-232-7057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 HERRICK ST",
            "address_2": "STE 101",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019153012",
            "telephone_number": "978-927-4110",
            "fax_number": "978-232-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "NATHAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "NP258431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "NP9661",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.