Individual provider Active NPI

Susan Muita

  • Psychiatric/Mental Health Nurse Practitioner
  • Lawrence, MA
National Provider Identifier
1265200752
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2282941 Issued in MA
Practice address
6 Leeds Ter
Lawrence, MA 01843-3402
Phone
(781) 520-9164
NPI assigned
Dec 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2282941 MA Primary

Addresses

Primary practice location

6 Leeds Ter
Lawrence, MA 01843-3402

Mailing address

6 Leeds Ter
Lawrence, MA 01843-3402
Phone (781) 520-9164

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
I20240405000479 MA Practitioner - Nurse Practitioner 4284941873 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Supportive Behavioral Care of Ma LLCGroup PAC ID 8628346731, 103 clinicians

Practice addresses (Care Compare)

44 School St
RM 325
Boston, MA 02108-4209
Phone (718) 298-4375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2282941MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthdrive Behavioral Health Services, PLLC Psychiatric/Mental Health CurrentSince Feb 1, 2024 Accepting new patients
Supportive Behavioral Care of Ma LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

44 School St
Rm 325
Boston, MA 02108
Phone (508) 831-8558

100 Crossing Blvd
Ste 300
Framingham, MA 01702
Phone (857) 255-0486

103 Myron St
Ste A
West Springfield, MA 01089
Phone (978) 388-1010

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

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": "1702512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1265200752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 LEEDS TER",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018433402",
            "telephone_number": "781-520-9164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 LEEDS TER",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018433402",
            "telephone_number": "781-520-9164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUITA",
        "first_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-14",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2282941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.