Individual provider Active NPI

Elizabeth Gruber, RN, MSN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cohasset, MA
National Provider Identifier
1487041844
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN198037 Issued in MA
Practice address
759 CJC Hwy # 226
Cohasset, MA 02025-2115
Phone
(781) 307-0505
NPI assigned
Apr 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN198037 MA Primary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X RN198037 MA

Addresses

Primary practice location

759 CJC Hwy # 226
Cohasset, MA 02025-2115

Mailing address

759 CJC Hwy # 226
Cohasset, MA 02025-2115
Phone (781) 307-0505

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
I20170112001054 MA Practitioner - Nurse Practitioner 5395027080 Practice locations: South Weymouth, MA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

759 Chief Justice Cushing Hwy
Cohasset, MA 02025-2115

851 Main St
Suite 16
South Weymouth, MA 02190-1613
Phone (781) 812-2701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN198037MAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1487041844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "759 CJC HWY # 226",
            "city": "COHASSET",
            "state": "MA",
            "postal_code": "020252115",
            "telephone_number": "781-307-0505",
            "fax_number": "781-383-2317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "759 CJC HWY # 226",
            "city": "COHASSET",
            "state": "MA",
            "postal_code": "020252115",
            "telephone_number": "781-307-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBER",
        "first_name": "ELIZABETH",
        "credential": "RN, MSN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-22",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN198037",
            "primary": true
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "RN198037",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cohasset, MA

Sources for this page

Verify at the official NPI Registry.