Individual provider Active NPI

Kerry A Willey, NP

  • Family Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1417250580
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
260333 Issued in MA
Practice address
116 Belmont St
Suite 12
Worcester, MA 01605-2964
Phone
(508) 770-1602
Fax
(508) 770-1605
NPI assigned
Dec 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 260333 MA Primary

Addresses

Primary practice location

116 Belmont St
Suite 12
Worcester, MA 01605-2964

Mailing address

116 Belmont St
Suite 12
Worcester, MA 01605-2964
Phone (508) 770-1602

Other names 1

  • Kerry A Treacy Former name

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
I20110309000513 MA Practitioner - Nurse Practitioner 2769664960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2000 Washington St
White BLDG Suite 546
Newton, MA 02462-1624
Phone (617) 964-5020

Hospital & facility affiliations

  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Suburban Massachusetts Inc CurrentSince Apr 27, 2016 Accepting new patients
Preventive Medicine Associates Past Accepting new patients
Brighton Family Practice, Inc Past Accepting new patients

Locations

2000 Washington St
Ste 546
Newton Lower Falls, MA 02462
Phone (617) 964-5020

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

2000 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

Interoperability endpoints

  • Direct secure messaging: willey.kerry.nwi@direct.partners.masshiway.net

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1292198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1417250580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 BELMONT ST",
            "address_2": "SUITE 12",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052964",
            "telephone_number": "508-770-1602",
            "fax_number": "508-770-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 BELMONT ST",
            "address_2": "SUITE 12",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052964",
            "telephone_number": "508-770-1602",
            "fax_number": "508-770-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLEY",
        "first_name": "KERRY",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-13",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "260333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRY",
            "last_name": "TREACY",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.