Individual provider Active NPI

James Quaicoe, NP

  • Adult Health Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1215447131
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
8887 Issued in CT
Practice address
29 Narragansett Ave
Worcester, MA 01607-1558
Phone
(508) 309-5676
NPI assigned
Oct 5, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2200X 8887 CT Primary
Acute Care Nurse Practitioner 363LA2100X RN2297807 MA

Addresses

Primary practice location

29 Narragansett Ave
Worcester, MA 01607-1558

Mailing address

5 Founders St
Ste 102
Willimantic, CT 06226-2050
Phone (508) 309-5676

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
I20180214002681 MA Practitioner - Nurse Practitioner 0345500229 Reassigns benefits to 2 organizations

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
The Commonwealth of MassachusettsGroup PAC ID 8820906860, 141 clinicians

Practice addresses (Care Compare)

309 Belmont St
Worcester, MA 01604-1059
Phone (508) 368-0704

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2297807MAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Medical Plus Single Specialty CurrentSince Jun 1, 2022 Accepting new patients
The Commonwealth of Massachusetts Single Specialty CurrentSince Sep 17, 2022 Accepting new patients
The Commonwealth of Massachusetts Single Specialty CurrentSince Sep 17, 2022 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

3 Allied Dr
Dedham, MA 02026
Phone (404) 587-0945

Interoperability endpoints

  • Direct secure messaging: james.quaicoe@xdr.hhchealthdirect.org

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1507161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1215447131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 FOUNDERS ST",
            "address_2": "STE 102",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262050",
            "telephone_number": "508-309-5676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 NARRAGANSETT AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016071558",
            "telephone_number": "508-309-5676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAICOE",
        "first_name": "JAMES",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-05",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "8887",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "RN2297807",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.