Individual provider Active NPI

Julie Phaneuf, NP

  • Nurse Practitioner
  • Salem, MA
National Provider Identifier
1316991623
Registry record updated Mar 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
181200 Issued in MA
Practice address
35 Congress St
Salem, MA 01970
Phone
(978) 825-7124
Fax
(978) 741-3890
NPI assigned
May 20, 2006
Last updated
Mar 29, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 181200 MA Primary

Addresses

Primary practice location

35 Congress St
Salem, MA 01970

Mailing address

PO Box 930
Salem, MA 01970
Phone (978) 825-7124

Other identifiers 1

IdentifierTypeStateIssuer
0706744MedicaidMA

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
I20050628000185 MA Practitioner - Nurse Practitioner 5092750224 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine Physicians of the North Shore LLCGroup PAC ID 5193798635, 5 clinicians

Practice addresses (Care Compare)

27 Centennial Dr
Peabody, MA 01960-7901
Phone (978) 531-7677

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
181200MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charter Health PC CurrentSince Mar 11, 2017 Accepting new patients
Internal Medicine Physicians of the North Shore LLC CurrentSince Sep 16, 2022 Accepting new patients

Locations

27 Centennial Dr
Peabody, MA 01960
Phone (978) 531-7677

55 Highland Ave
Ste 304
Salem, MA 01970
Phone (978) 354-4611

Interoperability endpoints

  • Direct secure messaging: phaneuf.julie.nsmc@direct.partners.masshiway.net

Organizations & group practices 2

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 4

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364515200000",
    "number": "1316991623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 930",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "01970",
            "telephone_number": "978-825-7124",
            "fax_number": "978-741-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 CONGRESS ST",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "01970",
            "telephone_number": "978-825-7124",
            "fax_number": "978-741-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHANEUF",
        "first_name": "JULIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2013-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "181200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0706744",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

Verify at the official NPI Registry.