Active NPI
Agnes N Opara
- Family Nurse Practitioner
- Charlestown, MA
National Provider Identifier
1215227905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN196566
- Practice address
- 529 Main St Ste 216
Charlestown, MA 02129-1122 - Phone
- (617) 600-3195
- NPI assigned
- Apr 14, 2011
- Last updated
- Apr 14, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN196566 | MA | |
| Family Nurse Practitioner | 363LF0000X | RN196566 | MA | Primary |
Addresses
Primary practice location
529 Main St Ste 216
Charlestown, MA 02129-1122
Mailing address
387 Salem St # 2
Medford, MA 02155-3339
Phone (781) 391-2621
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 363L00000X | Medicaid | MA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN196566 | MA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Commonwealth Care Alliance | Past | Accepting new patients |
Interoperability endpoints
- agnes.opara@ccalliance.eclinicaldirectplus.com
- https://api.commonwealthcarealliance.org/fhir/patientaccess/
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.
-
- Health Maintenance Organization
- Charlestown, MA
- NPI 1295195162
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302739200000",
"number": "1215227905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "387 SALEM ST # 2",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021553339",
"telephone_number": "781-391-2621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "529 MAIN ST STE 216",
"city": "CHARLESTOWN",
"state": "MA",
"postal_code": "021291122",
"telephone_number": "617-600-3195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OPARA",
"first_name": "AGNES",
"middle_name": "N",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-14",
"last_updated": "2011-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MA",
"license": "RN196566",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MA",
"license": "RN196566",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "363L00000X",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Charlestown, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.