Individual provider Active NPI

Mary Immaculate Nankya, MHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Woburn, MA
National Provider Identifier
1376406314
Registry record updated Dec 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2357600 Issued in MA
Practice address
241 Lexington St # 5
Woburn, MA 01801-5945
Phone
(857) 352-7186
NPI assigned
Dec 6, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2025

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 RN2357600 MA Primary

Addresses

Primary practice location

241 Lexington St # 5
Woburn, MA 01801-5945

Mailing address

241 Lexington St # 5
Woburn, MA 01801-5945

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
I20260406003526 MA Practitioner - Nurse Practitioner 9133694300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

90 Everett Ave
Suite 12
Chelsea, MA 02150-2317
Phone (617) 307-4228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2357600MAMDPsychiatric/Mental Health Nurse Practitioner

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": "1764979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764979200000",
    "number": "1376406314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 LEXINGTON ST # 5",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018015945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 LEXINGTON ST # 5",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018015945",
            "telephone_number": "857-352-7186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANKYA",
        "first_name": "MARY",
        "middle_name": "IMMACULATE",
        "credential": "MHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-06",
        "last_updated": "2025-12-06",
        "certification_date": "2025-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2357600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

Verify at the official NPI Registry.