Individual provider Active NPI

Andrew Wenstrom, CNP

  • Nurse Practitioner
  • Norwood, MA
National Provider Identifier
1194332577
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2310826 Issued in MA
Practice address
12 Hemlock St
Norwood, MA 02062-5616
Phone
(781) 789-4910
NPI assigned
Sep 29, 2020
Last updated
Sep 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 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 RN2310826 MA Primary

Addresses

Primary practice location

12 Hemlock St
Norwood, MA 02062-5616

Mailing address

12 Hemlock St
Norwood, MA 02062-5616
Phone (781) 789-4910

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
I20210105003152 MA Practitioner - Nurse Practitioner 0143633446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Supportive Behavioral Care of Ma LLCGroup PAC ID 8628346731, 103 clinicians

Practice addresses (Care Compare)

44 School St
RM 325
Boston, MA 02108-4209
Phone (718) 298-4375

Merit-based Incentive Payment System (MIPS)

Final score
86.67 of 100Reported as group
Quality
71.18
Improvement activities
40
Cost
75.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2310826MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Behavioral Care of Ma LLC CurrentSince Oct 5, 2020 Accepting new patients

Locations

44 School St
Rm 325
Boston, MA 02108
Phone (508) 831-8558

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

27 Randolph Rd
#A
Howell, NJ 07731
Phone (732) 797-9290

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1194332577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HEMLOCK ST",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625616",
            "telephone_number": "781-789-4910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 HEMLOCK ST",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625616",
            "telephone_number": "781-789-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENSTROM",
        "first_name": "ANDREW",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-29",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2310826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

Verify at the official NPI Registry.