Individual provider Active NPI

Stephany Boafo Gyasi, CNP

  • Family Nurse Practitioner
  • Boston, MA
National Provider Identifier
1508369166
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2305708 Issued in MA
Practice address
84 State Strret
Boston, MA 02109-2202
Phone
(860) 788-6404
Fax
(860) 398-6441
NPI assigned
Mar 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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 RN2305708 MA Primary

Addresses

Primary practice location

84 State Strret
Boston, MA 02109-2202

Mailing address

PO Box 1595
Middletown, CT 06457-8095
Phone (860) 788-6404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, ME2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180327001198 MA Practitioner - Certified Clinical Nurse Specialist (CNS) 1355603663 Reassigns benefits to 1 organization
I20240320001760 ME Practitioner - Nurse Practitioner 1355603663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medoptions of Maine LLCGroup PAC ID 8820374796, 15 clinicians
Meditelecare of Massachusetts, PLLCGroup PAC ID 8921417064, 14 clinicians

Practice addresses (Care Compare)

2 Footbridge Rd
Belfast, ME 04915-7206
Phone (860) 788-6404

84 State St
Boston, MA 02109-2202
Phone (860) 788-6404

Hospital & facility affiliations

  • Orono Commons Nursing home, Orono, ME, CCN 205031
  • Oak Grove Center Nursing home, Waterville, ME, CCN 205091

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2305708MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Meditelecare of Massachusetts, PLLC CurrentSince Mar 1, 2021 Accepting new patients
Medoptions of Maine, LLC CurrentSince Mar 1, 2024 Accepting new patients
Waterville SNF Operations, LLC Past Accepting new patients

Locations

84 State St
Ste 660
Boston, MA 02109
Phone (410) 832-2279

84 State St
Boston, MA 02109
Phone (855) 777-2244

23 Cedar Ridge Dr
Skowhegan, ME 04976
Phone (207) 474-9686

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1508369166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1595",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064578095",
            "telephone_number": "860-788-6404",
            "fax_number": "860-398-6441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 STATE STRRET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021092202",
            "telephone_number": "860-788-6404",
            "fax_number": "860-398-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GYASI",
        "first_name": "STEPHANY",
        "middle_name": "BOAFO",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-09",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2305708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.