Rahimetou Mbouombouo, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN2299168 Issued in MA

Practice address

365 East St
Tewksbury, MA 01876-1950

Phone

(978) 851-7321

NPI assigned

Apr 5, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

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)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• The Commonwealth of Massachusetts

  dba Tewksbury Hospital

  • Long Term Care Hospital
  • Tewksbury, MA
  • NPI 1871680496
  Medicare reassignment Care Compare group NPD
• Compassionate Home Health Care, LLC

  • Home Health Agency
  • Lowell, MA
  • NPI 1619860657
  NPD Authorized official
• The Commonwealth of Massachusetts

  dba Soldiers' Home in Holyoke

  • General Acute Care Hospital
  • Holyoke, MA
  • NPI 1427111574
  NPD

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

{
    "created_epoch": "1743811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743811200000",
    "number": "1265226310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 AMESBURY ST",
            "city": "DRACUT",
            "state": "MA",
            "postal_code": "018265648",
            "telephone_number": "978-349-8478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 EAST ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018761950",
            "telephone_number": "978-851-7321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBOUOMBOUO",
        "first_name": "RAHIMETOU",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-05",
        "last_updated": "2025-04-05",
        "certification_date": "2025-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2299168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Margosian, RPH
• Thomas Phillip Martin, PH.D.
• Mark Victor Mastone, ATC
• Gillian Matos
• Mackenzie Mayer, DVM
• Julie McCarthy, DPT
• Melissa McCormack, RD, LDN
• Mark A McGee, O.D.
• Bette L McInnis-Ippolito, PHD
• Michelle Charney McIntosh, PMHCNS-BC

• Psychiatric/Mental Health Nurse Practitioner in Tewksbury, MA
• Providers in Tewksbury, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.