Individual provider Active NPI

Alicyn Walsh

  • Family Nurse Practitioner
  • Marlborough, MA
National Provider Identifier
1245689652
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
272299 Issued in MA
Practice address
246 Maple St
Marlborough, MA 01752-3235
Phone
(508) 460-3872
Fax
(508) 357-4150
NPI assigned
Jun 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 272299 MA Primary

Addresses

Primary practice location

246 Maple St
Marlborough, MA 01752-3235

Mailing address

246 Maple St
Marlborough, MA 01752-3235
Phone (508) 460-3872

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
I20160808001292 MA Practitioner - Nurse Practitioner 0345534715 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vantage Healthcare LLCGroup PAC ID 8224361191, 72 clinicians

Practice addresses (Care Compare)

45 Dan Rd
Canton, MA 02021-2852
Phone (781) 867-2050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
272299MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vantage Healthcare LLC CurrentSince Dec 15, 2023 Accepting new patients
New Great Health Medical Ma PC CurrentSince Nov 27, 2024 Accepting new patients
Ajay Anand MD PC CurrentSince Sep 1, 2017 Accepting new patients
Ajay Anand MD PC Past Accepting new patients

Locations

277 Washington St
Abington, MA 02351
Phone (781) 871-0200

45 Dan Rd
Canton, MA 02021
Phone (781) 318-3609

111 Orient Ave
East Boston, MA 02128
Phone (617) 569-1200

407 Willoughby Ave
Brooklyn, NY 11205
Phone (212) 201-1252

Organizations & group practices 4

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1245689652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 MAPLE ST",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523235",
            "telephone_number": "508-460-3872",
            "fax_number": "508-357-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 MAPLE ST",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523235",
            "telephone_number": "508-460-3872",
            "fax_number": "508-357-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "ALICYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "272299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlborough, MA

Sources for this page

Verify at the official NPI Registry.