Individual provider Active NPI

Musa Ahmed Mugenyi, RN, BSN, NP

  • Gerontology Nurse Practitioner
  • Belmont, MA
National Provider Identifier
1417722612
Registry record updated Apr 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN2308093 Issued in MA
Practice address
87 Grove St
Belmont, MA 02478-3710
Phone
(978) 230-9377
NPI assigned
Nov 17, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X RN2308093 MA
Gerontology Nurse Practitioner 363LG0600X RN2308093 MA Primary

Addresses

Primary practice location

87 Grove St
Belmont, MA 02478-3710

Mailing address

87 Grove St
Belmont, MA 02478-3710
Phone (978) 230-9377

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
I20240424001372 MA Practitioner - Nurse Practitioner 7214224401 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

87 Grove St
Belmont, MA 02478-3710

Hospital & facility affiliations

  • Bayada Home Health Care, Inc Home health agency, Canton, MA, CCN 227551
  • Caretenders Home health agency, Needham Heights, MA, CCN 227269
  • Good Shepherd Community Care Hospice, Newton, MA, CCN 221500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN2308093MAMDCase Management Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Healthcare, LLC CurrentSince Jun 1, 2024 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Feb 1, 2025 Accepting new patients
Truewell Community Care Inc CurrentSince Nov 19, 2023 Accepting new patients
Vantage Healthcare LLC CurrentSince Mar 18, 2024 Accepting new patients

Locations

155 Federal St
Ste 700
Boston, MA 02110
Phone (469) 466-7420

45 Dan Rd
Canton, MA 02021
Phone (781) 318-3609

111 Orient Ave
East Boston, MA 02128
Phone (617) 569-1200

101 Station Dr
Ste 240
Westwood, MA 02090
Phone (781) 706-1079

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 4

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 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": "1700179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713052800000",
    "number": "1417722612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 GROVE ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024783710",
            "telephone_number": "978-230-9377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 GROVE ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024783710",
            "telephone_number": "978-230-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUGENYI",
        "first_name": "MUSA",
        "middle_name": "AHMED",
        "credential": "RN, BSN, NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-17",
        "last_updated": "2024-04-14",
        "certification_date": "2024-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "MA",
            "license": "RN2308093",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN2308093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, MA

Sources for this page

Verify at the official NPI Registry.