Individual provider Active NPI

Michelle A. Harwick, FNP, PMHNP

  • Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1184809626
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN164081 Issued in MA
Practice address
26 Queen Street
Worcester, MA 01610-2473
Phone
(508) 860-7800
NPI assigned
Jan 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN164081 MA Primary

Addresses

Primary practice location

26 Queen Street
Worcester, MA 01610-2473

Mailing address

26 Queen Street
Worcester, MA 01610-2473
Phone (508) 860-7700

Other practice location 1

55 Lake Ave N
Department of Emergency Medicine
Worcester, MA 01655-0002
Phone (508) 421-1400

Other identifiers 1

IdentifierTypeStateIssuer
0717053MedicaidMA

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
I20080124000088 MA Practitioner - Nurse Practitioner 2264514660

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: mharwick604593@direct.medicine.duke.edu

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1184809626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 QUEEN STREET",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102473",
            "telephone_number": "508-860-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 QUEEN STREET",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102473",
            "telephone_number": "508-860-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Lake Ave N",
            "address_2": "Department of Emergency Medicine",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-421-1400",
            "fax_number": "508-421-1490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARWICK",
        "first_name": "MICHELLE",
        "middle_name": "A.",
        "credential": "FNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-03",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN164081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0717053",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.