Individual provider Active NPI

Robin A Ralicki, N.P.

  • Family Nurse Practitioner
  • Greenfield, MA
National Provider Identifier
1497719090
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
100668 Issued in MA
Practice address
329 Conway St
Greenfield Health Center
Greenfield, MA 01301-1526
Phone
(413) 774-6301
Fax
(413) 774-6528
NPI assigned
Apr 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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 100668 MA Primary

Addresses

Primary practice location

329 Conway St
Greenfield Health Center
Greenfield, MA 01301-1526

Mailing address

PO Box 8019
Springfield, MA 01102-8000
Phone (866) 431-4077

Other identifiers 5

IdentifierTypeStateIssuer
100668OtherMACONNECTICARE
NP1663OtherMABLUE CROSS BLUE SHIELD
500016130OtherMARAILROAD MEDICARE
1295087OtherMAFALLON COMMUNITY HEALTH PLAN
0351041MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100668MAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1497719090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8019",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011028000",
            "telephone_number": "866-431-4077",
            "fax_number": "413-774-7448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 CONWAY ST",
            "address_2": "GREENFIELD HEALTH CENTER",
            "city": "GREENFIELD",
            "state": "MA",
            "postal_code": "013011526",
            "telephone_number": "413-774-6301",
            "fax_number": "413-774-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RALICKI",
        "first_name": "ROBIN",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "100668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "100668",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "NP1663",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "500016130",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMMUNITY HEALTH PLAN",
            "identifier": "1295087",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0351041",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.