Individual provider Active NPI

Vivens Ulysse

  • Psychiatric/Mental Health Nurse Practitioner
  • Walpole, MA
National Provider Identifier
1487332615
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2282687 Issued in MA
Practice address
420 Main St
Walpole, MA 02081-3753
Phone
(617) 514-2495
NPI assigned
Jul 7, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2282687 MA Primary

Addresses

Primary practice location

420 Main St
Walpole, MA 02081-3753

Mailing address

28 Columbus Ave
Stoughton, MA 02072-3214
Phone (781) 228-9627

Other names 1

  • Mr. Vivens Ulysse Professional name

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
I20231016001827 MA Practitioner - Nurse Practitioner 2668827304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neuro Behavioral Center LLCGroup PAC ID 9032410667, 13 clinicians

Practice addresses (Care Compare)

420 Main St
Suite 15
Walpole, MA 02081-3753
Phone 50866016661305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Walpole Physical Therapy Services, Inc CurrentSince Jul 9, 2023 Accepting new patients
Neuro Behavioral Center, LLC CurrentSince Aug 14, 2023 Accepting new patients
Boston Neurobehavioral Associates, LLC PastSince Jul 9, 2023 Accepting new patients

Locations

420 Main St
Ste 15
Walpole, MA 02081
Phone (508) 660-1666

420 Main St
Walpole, MA 02081
Phone (508) 660-7949

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1487332615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 COLUMBUS AVE",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020723214",
            "telephone_number": "781-228-9627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 MAIN ST",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020813753",
            "telephone_number": "617-514-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULYSSE",
        "first_name": "VIVENS",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2282687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIVENS",
            "last_name": "ULYSSE",
            "prefix": "MR.",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Walpole, MA

Sources for this page

Verify at the official NPI Registry.