Individual provider Active NPI

Thelora Edwhyne Marseille, FNP-C

  • Family Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1295491074
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2326418 Issued in MA
Practice address
44 W Boylston St
Worcester, MA 01605-1261
Phone
(508) 852-0238
NPI assigned
Nov 16, 2021
Last updated
Apr 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2326418 MA Primary
Registered Nurse 163W00000X RN2326418 MA

Addresses

Primary practice location

44 W Boylston St
Worcester, MA 01605-1261

Mailing address

1 Weatherbee Rd
Shirley, MA 01464-2522

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
I20240604003423 MA Practitioner - Nurse Practitioner 3577005669 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Massachusetts, LLCGroup PAC ID 2264594944, 106 clinicians

Practice addresses (Care Compare)

24 W Main St
Northborough, MA 01532-1910
Phone (866) 389-2727

246 Mill St
Leominster, MA 01453-3310
Phone (866) 389-2727

311 Newbury St
Danvers, MA 01923-1027
Phone (866) 389-2727

44 W Boylston St
Worcester, MA 01605-1261
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2326418MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Massachusetts LLC Single Specialty CurrentSince May 2, 2024 Accepting new patients

Locations

270 Grove St
Braintree, MA 02184
Phone (781) 356-0714

311 Newbury St
Danvers, MA 01923
Phone (978) 605-0100

1025 Central St
Stoughton, MA 02072
Phone 7813416114 ext. 8221

44 W Boylston St
Worcester, MA 01605
Phone (508) 852-0238

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1637020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1295491074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WEATHERBEE RD",
            "city": "SHIRLEY",
            "state": "MA",
            "postal_code": "014642522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 W BOYLSTON ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016051261",
            "telephone_number": "508-852-0238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSEILLE",
        "first_name": "THELORA",
        "middle_name": "EDWHYNE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-16",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2326418",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2326418",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.