Individual provider Active NPI

Robynn Lee Eisley, FNP

  • Family Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1467637702
Registry record updated May 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN266626 Issued in MA
Practice address
19 Tacoma St
Worcester, MA 01605-3516
Phone
(508) 852-1805
Fax
(508) 853-8593
NPI assigned
Jan 7, 2008
Last updated
May 27, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2014

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 RN266626 MA Primary

Addresses

Primary practice location

19 Tacoma St
Worcester, MA 01605-3516

Mailing address

19 Tacoma St
Worcester, MA 01605-3516
Phone (508) 852-1805

Other identifiers 1

IdentifierTypeStateIssuer
1301071OtherMAMEDICAID GROUP #

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
I20080307000357 MA Practitioner - Nurse Practitioner 8527143015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Massachusetts Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

605 Lincoln St
Worcester, MA 01605-1901
Phone (800) 853-2288

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN266626MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Feb 4, 2008 Accepting new patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Feb 4, 2008 Accepting new patients
Edward M. Kennedy Community Health Center, Inc Past Accepting new patients
Edward M. Kennedy Community Health Center, Inc Past Accepting new patients

Locations

41 Cape Rd
Milford, MA 01757
Phone (508) 270-5750

19 Tacoma St
Worcester, MA 01605
Phone (508) 854-2122

605 Lincoln St
Worcester, MA 01605
Phone (508) 856-0104

650 Lincoln St
Worcester, MA 01605
Phone (508) 532-7318

Interoperability endpoints

  • Direct secure messaging: robynn.eisley.p1@direct.emkchc.nextgenshare.com

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": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401148800000",
    "number": "1467637702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 TACOMA ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053516",
            "telephone_number": "508-852-1805",
            "fax_number": "508-853-8593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 TACOMA ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053516",
            "telephone_number": "508-852-1805",
            "fax_number": "508-853-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISLEY",
        "first_name": "ROBYNN",
        "middle_name": "LEE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-07",
        "last_updated": "2014-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN266626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP #",
            "identifier": "1301071",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.