Individual provider Active NPI

Rachel Grandstrand, FNP-BC

  • Student in an Organized Health Care Education/Training Program
  • Dover, MA
National Provider Identifier
1205548252
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
17 Saddle Ridge Rd
Dover, MA 02030-1639
Phone
(310) 991-3427
NPI assigned
Dec 21, 2022
Last updated
Dec 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

17 Saddle Ridge Rd
Dover, MA 02030-1639

Mailing address

17 Saddle Ridge Rd
Dover, MA 02030-1639
Phone (310) 991-3427

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
I20230605001786 MA Practitioner - Nurse Practitioner 6305203464 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care of Boston Management Corporation CurrentSince Jun 5, 2023 Accepting new patients

Locations

817 Highland Ave
Needham Heights, MA 02494
Phone (781) 449-5170

93 Pond St
Sharon, MA 02067
Phone (781) 784-9212

Interoperability endpoints

  • Direct secure messaging: rgrandstrand253213@direct.bilh.masshiway.net

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": "1671580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1205548252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SADDLE RIDGE RD",
            "city": "DOVER",
            "state": "MA",
            "postal_code": "020301639",
            "telephone_number": "310-991-3427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 SADDLE RIDGE RD",
            "city": "DOVER",
            "state": "MA",
            "postal_code": "020301639",
            "telephone_number": "310-991-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDSTRAND",
        "first_name": "RACHEL",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-21",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, MA

Sources for this page

Verify at the official NPI Registry.