Individual provider Active NPI

Heather Archambeault, CRNA

  • Certified Registered Nurse Anesthetist
  • Worcester, MA
National Provider Identifier
1285659128
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN238401 Issued in MA
Practice address
123 Summer St
Worcester, MA 01608-1216
Phone
(508) 363-6030
NPI assigned
Jul 13, 2006
Last updated
Feb 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN238401 MA Primary

Addresses

Primary practice location

123 Summer St
Worcester, MA 01608-1216

Mailing address

51 Beaman Rd
Princeton, MA 01541-1113

Other practice location 1

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-3271

Other identifiers 1

IdentifierTypeStateIssuer
110107204AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050207000337 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082665187 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Heywood Memorial HospitalGroup PAC ID 1658262605, 116 clinicians
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

242 Green St
Gardner, MA 01440-1336
Phone (978) 632-3420

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN238401MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Heywood Memorial Hospital CurrentSince Dec 1, 2015 Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Dec 1, 2015 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Mar 9, 2022 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Mar 9, 2022 Accepting new patients
Saint Vincent Physician Services, Inc. PastSince Aug 17, 2010 Accepting new patients
Anesthetics of Worcester, PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

123 Summer St
#273
Worcester, MA 01608
Phone (508) 363-6327

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1285659128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 BEAMAN RD",
            "city": "PRINCETON",
            "state": "MA",
            "postal_code": "015411113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-363-6030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-334-3271",
            "fax_number": "508-856-5911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARCHAMBEAULT",
        "first_name": "HEATHER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN238401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110107204A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.