Individual provider Active NPI

Barbara A Roderick, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • New Bedford, MA
National Provider Identifier
1295084002
Registry record updated Aug 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN235938 Issued in MA
Practice address
70 Kilburn St
New Bedford, MA 02740
Phone
(508) 984-1697
NPI assigned
Sep 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2016

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 RN235938 MA Primary

Addresses

Primary practice location

70 Kilburn St
New Bedford, MA 02740

Mailing address

70 Kilburn St
New Bedford, MA 02740

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
I20151202000564 MA Practitioner - Nurse Practitioner 1658671326 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Huffman Enterprises IncGroup PAC ID 1153564331, 15 clinicians

Practice addresses (Care Compare)

516 Hawthorn St
Suite 4
Dartmouth, MA 02747-3733
Phone (774) 929-7420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Oct 15, 2015 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Oct 15, 2015 Accepting new patients
WP Acquisition Sub LLC CurrentSince Apr 1, 2022 Accepting new patients
WP Acquisition Sub LLC CurrentSince Apr 1, 2022 Accepting new patients
Huffman Enterprises, Inc CurrentSince May 7, 2023 Accepting new patients
Northeast Behavioral Health, LLC CurrentSince Jan 1, 2018 Accepting new patients

Locations

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

76 Summer St
Haverhill, MA 01830
Phone (978) 258-4734

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

516 Hawthorn St
Ste 4
North Dartmouth, MA 02747
Phone (774) 919-7420

581 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 207-9800

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471564800000",
    "number": "1295084002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 KILBURN ST",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "02740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 KILBURN ST",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "02740",
            "telephone_number": "508-984-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODERICK",
        "first_name": "BARBARA",
        "middle_name": "A",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-07",
        "last_updated": "2016-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN235938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bedford, MA

Sources for this page

Verify at the official NPI Registry.