Individual provider Active NPI

Muayna Yasir Elsir, CNM

  • Midwife
  • Brockton, MA
National Provider Identifier
1427518307
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
RN2309109 Issued in MA
Practice address
63 Main St
Brockton, MA 02301-4042
Phone
(508) 559-6699
NPI assigned
Mar 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X RN2309109 MA Primary

Addresses

Primary practice location

63 Main St
Brockton, MA 02301-4042

Mailing address

63 Main St
Brockton, MA 02301-4042

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190614001816 MA Practitioner - Certified Nurse Midwife (CNM) 8921331471 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2309109MAMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Brockton Neighborhood Health Center, Inc. CurrentSince May 29, 2019 Accepting new patients
Obhg Massachusetts - Direct, P.C. CurrentSince Sep 1, 2024 Accepting new patients
Brockton Neighborhood Health Center Current Accepting new patients
Brockton Neighborhood Health Center CurrentSince May 29, 2019 Accepting new patients
Obhg Massachusetts PC Past Accepting new patients
Brockton Neighborhood Health Center Past Accepting new patients

Locations

158 Pleasant St
Brockton, MA 02301
Phone (508) 559-6699

63 Main St
Brockton, MA 02301
Phone (508) 559-6696

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

Interoperability endpoints

  • FHIR API: https://epicproxy.et1290.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: melsir19184@direct.ctc.masshiway.net

Organizations & group practices 7

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": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1427518307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014042",
            "telephone_number": "508-559-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSIR",
        "first_name": "MUAYNA",
        "middle_name": "YASIR",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "MA",
            "license": "RN2309109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.