Individual provider Active NPI

Devi Sivanandan

  • Adult Health Nurse Practitioner
  • Andover, MA
National Provider Identifier
1407460322
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN2297068 Issued in MA
Practice address
18 Dale St Unit 5C
Andover, MA 01810-5663
Phone
(857) 225-3948
NPI assigned
Sep 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN2297068 MA Primary

Addresses

Primary practice location

18 Dale St Unit 5C
Andover, MA 01810-5663

Mailing address

4 Virginia LN
Stoneham, MA 02180-3337
Phone (857) 225-3948

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
I20200922002242 MA Practitioner - Nurse Practitioner 4587082656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
360 Healthcare LLCGroup PAC ID 5597131532, 30 clinicians

Practice addresses (Care Compare)

585 Lebanon St
Melrose, MA 02176-3225
Phone (781) 488-6843

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2297068MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
360 Healthcare LLC CurrentSince Jan 25, 2023 Accepting new patients

Locations

10 Mall Rd
Ste 305
Burlington, MA 01803

10 Mall Rd
Ste 301
Burlington, MA 01803
Phone (781) 488-6843

585 Lebanon St
Melrose, MA 02176
Phone (781) 979-3026

232 S Main St
Middleton, MA 01949
Phone (781) 480-1987

73 Chestnut St
Saugus, MA 01906
Phone (781) 231-8123

750 Woburn St
Wilmington, MA 01887
Phone (781) 488-6843

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": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1407460322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 VIRGINIA LN",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803337",
            "telephone_number": "857-225-3948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 DALE ST UNIT 5C",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018105663",
            "telephone_number": "857-225-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVANANDAN",
        "first_name": "DEVI",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-08",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2297068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MA

Sources for this page

Verify at the official NPI Registry.