Individual provider Active NPI

Robert M Conroy, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • South Yarmouth, MA
National Provider Identifier
1215513288
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2313759 Issued in MA
Practice address
9 Green Way
South Yarmouth, MA 02664-2027
Phone
(781) 859-7326
NPI assigned
Mar 22, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2313759 MA Primary
Registered Nurse 163W00000X RN2313759 MA

Addresses

Primary practice location

9 Green Way
South Yarmouth, MA 02664-2027

Mailing address

9 Green Way
South Yarmouth, MA 02664-2027
Phone (781) 859-7326

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
I20230605002592 MA Practitioner - Nurse Practitioner 0345607420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

40 Shattuck Rd
Suite 250
Andover, MA 01810-2492
Phone (978) 222-3121

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Jan 28, 2024 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Jan 28, 2024 Accepting new patients

Locations

40 Shattuck Rd
Ste 250
Andover, MA 01810
Phone (603) 505-6847

Interoperability endpoints

  • Direct secure messaging: robert.conroy.1@28623.direct.athenahealth.com

Organizations & group practices 2

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": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1215513288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 GREEN WAY",
            "city": "SOUTH YARMOUTH",
            "state": "MA",
            "postal_code": "026642027",
            "telephone_number": "781-859-7326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 GREEN WAY",
            "city": "SOUTH YARMOUTH",
            "state": "MA",
            "postal_code": "026642027",
            "telephone_number": "781-859-7326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONROY",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2313759",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2313759",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Yarmouth, MA

Sources for this page

Verify at the official NPI Registry.