Individual provider Active NPI

Linda Lotive Simwatachela, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Medford, MA
National Provider Identifier
1245847573
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2371987 Issued in MA
Practice address
26 City Hall Mall
Medford, MA 02155-4754
Phone
(781) 306-5100
NPI assigned
Sep 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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 2371987 MA Primary
Registered Nurse 163W00000X 95053526 CA

Addresses

Primary practice location

26 City Hall Mall
Medford, MA 02155-4754

Mailing address

26 City Hall Mall
Medford, MA 02155-4754
Phone (781) 306-5100

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
I20230220000493 MA Practitioner - Nurse Practitioner 4981076064

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

147 Milk St
Boston, MA 02109-4806

147 Milk St
Boston, MA 02109-4862

300 Apollo Dr
Chelmsford, MA 01824-3629

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95053526CAMDRegistered Nurse
2371987MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. CurrentSince Mar 20, 2023 Accepting new patients
Atrius Health, Inc. CurrentSince Mar 20, 2023 Accepting new patients
Atrius Health, Inc. Current Accepting new patients

Locations

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

26 City Hall Mall
Medford, MA 02155
Phone (781) 306-5100

Interoperability endpoints

  • Direct secure messaging: lchowanp366296@direct.atrius.masshiway.net

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": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1245847573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 CITY HALL MALL",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554754",
            "telephone_number": "781-306-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 CITY HALL MALL",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554754",
            "telephone_number": "781-306-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMWATACHELA",
        "first_name": "LINDA",
        "middle_name": "LOTIVE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2371987",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95053526",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.