Organization Active NPI

Somaform Health PLLC

  • Primary Care Nurse Practitioner
  • Tewksbury, MA
National Provider Identifier
1467315457
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
SOMAFORM HEALTH PLLC
Practice address
1764 Main St
Tewksbury, MA 01876-2004
Phone
(978) 678-5038
Fax
(728) 729-9841
NPI assigned
Dec 5, 2025
Last updated
May 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Authorized official

Name
Soimise VerdieuNPI 1134345960
Title
Founder & Ceo
Phone
(978) 678-5038

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

1764 Main St
Tewksbury, MA 01876-2004

Mailing address

1764 Main St
Tewksbury, MA 01876-2004
Phone (978) 678-5038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260330000519 MA Part B Supplier - Clinic/Group Practice 6507341401 Receives reassigned benefits from 1 practitioner
Practice locations: Lynnfield, MA

National Provider Directory

National Provider Directory

Locations

50 Salem St
Ste 204
Lynnfield, MA 01940
Phone (781) 587-2078

1764 Main St
Tewksbury, MA 01876
Phone (978) 678-5038

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1764892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1467315457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1764 MAIN ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018762004",
            "telephone_number": "978-678-5038",
            "fax_number": "728-729-9841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1764 MAIN ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018762004",
            "telephone_number": "978-678-5038",
            "fax_number": "728-729-9841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMAFORM HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-05",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "VERDIEU",
        "authorized_official_first_name": "SOIMISE",
        "authorized_official_title_or_position": "FOUNDER & CEO",
        "authorized_official_telephone_number": "978-678-5038"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tewksbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.