Individual provider Active NPI

Mary Torkornoo

  • Gerontology Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1205334588
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN233266 Issued in MA
Practice address
430 Massasoit Rd
Worcester, MA 01604-3546
Phone
(508) 648-8533
NPI assigned
Jan 31, 2018
Last updated
Jun 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN233266 MA Primary

Addresses

Primary practice location

430 Massasoit Rd
Worcester, MA 01604-3546

Mailing address

430 Massasoit Rd
Worcester, MA 01604-3546

Other identifiers 1

IdentifierTypeStateIssuer
233266MedicaidMA

Electronic endpoints 2

TypeEndpointUseAffiliation
SOAP URL EHR
SOAP URL EHR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN233266MAMDGerontology Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: mary.torkornoo.p1@direct.fallonhealth.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1205334588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 MASSASOIT RD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016043546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MASSASOIT RD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016043546",
            "telephone_number": "508-648-8533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORKORNOO",
        "first_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN233266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "233266",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "address_1": "430 Massasoit Rd",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016043546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "address_1": "430 Massasoit Rd",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016043546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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 Jun 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.