Individual provider Active NPI

Amy Kristen Aviles, F.N.P.

  • Family Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1497083984
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN260678 Issued in MA
Practice address
3 Aster PL
Worcester, MA 01603-2201
Phone
(508) 769-5875
NPI assigned
Nov 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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 RN260678 MA Primary

Addresses

Primary practice location

3 Aster PL
Worcester, MA 01603-2201

Mailing address

3 Aster PL
Worcester, MA 01603-2201
Phone (508) 769-5875

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
I20150515000144 MA Practitioner - Nurse Practitioner 0547427825 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc CurrentSince Mar 4, 2019 Accepting new patients
Minuteclinic Diagnostic of Massachusetts LLC Family CurrentSince Mar 2, 2015 Accepting new patients

Locations

311 Newbury St
Danvers, MA 01923
Phone (978) 605-0100

1025 Central St
Stoughton, MA 02072
Phone 7813416114 ext. 8221

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

Interoperability endpoints

  • Direct secure messaging: amy.aviles.npi1497083984.reliant@direct.optumcare.masshiway.net

Organizations & group practices 2

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": "1258934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1497083984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 ASTER PL",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016032201",
            "telephone_number": "508-769-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ASTER PL",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016032201",
            "telephone_number": "508-769-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILES",
        "first_name": "AMY",
        "middle_name": "KRISTEN",
        "credential": "F.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-23",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN260678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.