Individual provider Active NPI

Juanita Carnes, NP

  • Nurse Practitioner
  • Westfield, MA
National Provider Identifier
1275575342
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN177561 Issued in MA
Practice address
115 W Silver St
Westfield, MA 01085-3628
Phone
(413) 568-2811
Fax
(610) 834-2862
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 8

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 2

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

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooley Dickinson Hospital Inc (32 clinicians)
Mass General Brigham Medical Group Western Massachusetts Inc (291 clinicians)
Urgent Care Medical Associates, LLC (113 clinicians)

Practice addresses (Care Compare)

12 College Hwy
Southampton, MA 01073-9406
Phone (413) 527-1105

30 Locust St
Northampton, MA 01060-2052
Phone (413) 582-2330

55 Hazard Ave
Enfield, CT 06082-3826
Phone (860) 650-3848

Hospital & facility affiliations

  • Cooley Dickinson Hospital Inc,the Hospital · Northampton, MA · CCN 220015

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MA, CT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20100914000289 MA Practitioner - Nurse Practitioner 3678698719 Reassigns benefits to 2 organizations
I20191111000045 CT Practitioner - Nurse Practitioner 3678698719 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8161CTMDProfessional Counselor
RN177561MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cooley Dickinson Hospital Inc Current Accepting new patients
Cooley Dickinson Hospital Inc Current
since Oct 28, 2020
Accepting new patients
Mass General Brigham Medical Group Western Massachusetts Inc Current
since Nov 2, 2020
Accepting new patients
Hampshire Pathologists, Inc. Current Accepting new patients
Mass General Brigham Medical Group Western Massachusetts Inc Past Accepting new patients
WRK Ventures, LLC Past Accepting new patients

Locations

30 Locust St
Northampton, MA 01060
Phone (413) 582-2000

12 College Hwy
Southampton, MA 01073
Phone (413) 527-1105

Interoperability endpoints

  • Direct secure messaging: carnes.juanita.cdh@direct.partners.masshiway.net

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8161 CT
Nurse Practitioner 363L00000X RN177561 MA Primary

Addresses

NPPES NPI Registry

Primary practice location

115 W Silver St
Westfield, MA 01085-3628

Mailing address

1000 River Rd
Suite 100
Conshohocken, PA 19428-2439
Phone (800) 355-0505

Other practice location 1

55 Hazard Ave
Enfield, CT 06082-3826
Phone (860) 745-9911

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
0700631MedicaidMA
500030036OtherMARAILROAD MEDICARE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 30, 2020.

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1275575342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 RIVER RD",
            "address_2": "SUITE 100",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282439",
            "telephone_number": "800-355-0505",
            "fax_number": "610-834-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W SILVER ST",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010853628",
            "telephone_number": "413-568-2811",
            "fax_number": "610-834-2862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Hazard Ave",
            "address_purpose": "LOCATION",
            "city": "Enfield",
            "state": "CT",
            "postal_code": "060823826",
            "country_code": "US",
            "telephone_number": "860-745-9911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARNES",
        "first_name": "JUANITA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "8161",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN177561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0700631",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "500030036",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, MA

Sources for this page

Verify at the official NPI Registry.