Individual provider Active NPI

Edmund Adem, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1275190076
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2332683 Issued in MA
Practice address
26 Queen St Ste 13
Worcester, MA 01610-2478
Phone
(508) 860-7700
NPI assigned
May 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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 RN2332683 MA Primary

Addresses

Primary practice location

26 Queen St Ste 13
Worcester, MA 01610-2478

Mailing address

26 Queen St Ste 13
Worcester, MA 01610-2478
Phone (598) 860-7700

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
I20241125003917 MA Practitioner - Nurse Practitioner 8628503836 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Family Health Center of Worcester, Inc.Group PAC ID 4789670985, 94 clinicians
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

26 Queen St
Worcester, MA 01610-2473
Phone (508) 860-7800

405 Grove St
Suite 201
Worcester, MA 01605-1270
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2332683MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Center of Worcester, Inc. CurrentSince Dec 30, 2024 Accepting new patients
Family Health Center of Worcester, Inc. CurrentSince Dec 30, 2024 Accepting new patients
Adamfopa Outpatient Psychiatry PLLC Psychiatric/Mental Health Current Accepting new patients

Locations

26 Queen St
Worcester, MA 01610
Phone (508) 860-7700

26 Queen St
Ste 13
Worcester, MA 01610
Phone (508) 860-7700

Interoperability endpoints

  • Direct secure messaging: eadem49839@direct.ctc.masshiway.net

Organizations & group practices 5

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": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1275190076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 QUEEN ST STE 13",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102478",
            "telephone_number": "598-860-7700",
            "fax_number": "508-860-7865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 QUEEN ST STE 13",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102478",
            "telephone_number": "508-860-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEM",
        "first_name": "EDMUND",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-28",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2332683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.