Individual provider Active NPI

Karina Deandrade Reidy

  • Counselor
  • Mansfield, MA
National Provider Identifier
1285355628
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
20 Cabot Blvd Ste 227
Mansfield, MA 02048-1183
Phone
(508) 589-5333
NPI assigned
Sep 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

20 Cabot Blvd Ste 227
Mansfield, MA 02048-1183

Mailing address

400 Foxboro Blvd Apt 4201
Foxborough, MA 02035-3807
Phone (617) 388-3291

Other practice location 1

400 Foxboro Blvd Apt 4201
Foxborough, MA 02035-3807
Phone (617) 388-3291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vendetti Wellness Group, PC Single Specialty CurrentSince Sep 23, 2024 Accepting new patients

Locations

20 Cabot Blvd
Ste 227
Mansfield, MA 02048
Phone (508) 589-5333

Organizations & group practices 1

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": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1285355628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FOXBORO BLVD APT 4201",
            "city": "FOXBOROUGH",
            "state": "MA",
            "postal_code": "020353807",
            "telephone_number": "617-388-3291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CABOT BLVD STE 227",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020481183",
            "telephone_number": "508-589-5333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Foxboro Blvd Apt 4201",
            "address_purpose": "LOCATION",
            "city": "Foxborough",
            "state": "MA",
            "postal_code": "020353807",
            "country_code": "US",
            "telephone_number": "617-388-3291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REIDY",
        "first_name": "KARINA",
        "middle_name": "DEANDRADE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-05",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.