Individual provider Active NPI

Bernard Waigi

  • Psychiatry Physician
  • Brockton, MA
National Provider Identifier
1467079517
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
RN264544 Issued in MA
Practice address
940 Belmont St BLDG 2
Brockton, MA 02301-5596
Phone
(774) 696-3689
NPI assigned
Jul 5, 2020
Last updated
Jun 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X RN264544 MA Primary

Addresses

Primary practice location

940 Belmont St BLDG 2
Brockton, MA 02301-5596

Mailing address

18 Irene CT
Millbury, MA 01527-3701
Phone (774) 696-3689

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
I20221025001034 MA Practitioner - Nurse Practitioner 3779959226 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Circle Integrative Psychiatric GroupGroup PAC ID 7517314560, 3 clinicians

Practice addresses (Care Compare)

90 Madison St
Suite 302
Worcester, MA 01608-2072
Phone (508) 713-0297

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Healthlink, Inc. CurrentSince Oct 11, 2022 Accepting new patients
Community Healthlink Inc CurrentSince Oct 11, 2022 Accepting new patients
Ysabel Gomez Clinical Services LLC CurrentSince Oct 1, 2023 Accepting new patients
Circle Integrative Psychiatric Group CurrentSince Oct 1, 2023 Accepting new patients

Locations

40 Spruce St
#2
Leominster, MA 01453
Phone (978) 534-6116

12 Queen St
Worcester, MA 01610
Phone (508) 860-1036

162 Chandler St
Worcester, MA 01609
Phone (508) 860-1080

72 Jaques Ave
Worcester, MA 01610
Phone (508) 860-1154

90 Madison St
Ste 302
Worcester, MA 01608
Phone (508) 713-0297

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1467079517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 IRENE CT",
            "city": "MILLBURY",
            "state": "MA",
            "postal_code": "015273701",
            "telephone_number": "774-696-3689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 BELMONT ST BLDG 2",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015596",
            "telephone_number": "774-696-3689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAIGI",
        "first_name": "BERNARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-05",
        "last_updated": "2021-06-10",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "RN264544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.