Active NPI
Peninah Elizabeth Waithira
- Psychiatric/Mental Health Nurse Practitioner
- Southbridge, MA
National Provider Identifier
1487301768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- RN2298837
- Practice address
- 29 Pine St
Southbridge, MA 01550-1823 - Phone
- (508) 765-9167
- NPI assigned
- Mar 7, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | RN2298837 | MA | Primary |
Addresses
Primary practice location
29 Pine St
Southbridge, MA 01550-1823
Mailing address
PO Box 40
Southbridge, MA 01550-0040
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
411 Chandler St
Worcester, MA 01602-3339
Phone (508) 799-0688
90 Madison St
Suite 302
Worcester, MA 01608-2072
Phone (508) 713-0297
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2298837 | MA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Circle Integrative Psychiatric Group | Psychiatric/Mental Health | Current | Accepting new patients |
| Ysabel Gomez Clinical Services LLC | Current | Accepting new patients | |
| Hri Clinics, Inc. | Current | Accepting new patients | |
| Hri Clinics Inc | Current | Accepting new patients |
Locations
14 Fordham Rd
Boston, MA 02134
Phone (617) 783-9676
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 and National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- West Boylston, MA
- NPI 1730960733
-
- Community/Behavioral Health Agency
- Woburn, MA
- NPI 1598707002
-
- Community/Behavioral Health Agency
- Norwell, MA
- NPI 1922123199
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Worcester, MA
- NPI 1689158545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646611200000",
"number": "1487301768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 40",
"city": "SOUTHBRIDGE",
"state": "MA",
"postal_code": "015500040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 PINE ST",
"city": "SOUTHBRIDGE",
"state": "MA",
"postal_code": "015501823",
"telephone_number": "508-765-9167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAITHIRA",
"first_name": "PENINAH",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-07",
"last_updated": "2022-03-07",
"certification_date": "2022-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MA",
"license": "RN2298837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southbridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.