Individual provider Active NPI

Kristina Vassell, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Walpole, MA
National Provider Identifier
1538786645
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2021028901 Issued in MA
Practice address
420 Main St Ste 15
Walpole, MA 02081-3753
Phone
(508) 660-1666
Fax
(508) 660-1666
NPI assigned
Jul 6, 2020
Last updated
Nov 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry Physician 2084P0802X 2290360 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2021028901 MA Primary

Addresses

Primary practice location

420 Main St Ste 15
Walpole, MA 02081-3753

Mailing address

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 471-7791

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
I20210909003354 MA Practitioner - Nurse Practitioner 8325444797 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Vincent Physician Services IncGroup PAC ID 8921056276, 71 clinicians

Practice addresses (Care Compare)

123 Summer St
Suite 32S
Worcester, MA 01608-1216
Phone (508) 363-6196

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2290360MAMDAddiction Psychiatry Physician
2021028901MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Vincent Physician Services, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Vinfen Corporation CurrentSince Feb 19, 2024 Accepting new patients
Alliance Lifetime Mental Health, Inc CurrentSince Nov 2, 2022 Accepting new patients
Aspire Medical Group, P.C. Psychiatric/Mental Health CurrentSince Aug 1, 2022 Accepting new patients
Uhs of Westwood Pembroke Inc CurrentSince Dec 12, 2022 Accepting new patients

Locations

950 Cambridge St
Cambridge, MA 02141
Phone (617) 441-1743

275 Turnpike St
Ste 206
Canton, MA 02021
Phone (617) 991-9151

15 Union St
Ste 204
Lawrence, MA 01840
Phone (978) 209-4426

199 Oak St
Pembroke, MA 02359
Phone (781) 829-7000

123 Summer St
#273
Worcester, MA 01608
Phone (508) 363-6327

123 Summer St
Ste 32S
Worcester, MA 01608
Phone (508) 363-5189

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1538786645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-471-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 MAIN ST STE 15",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020813753",
            "telephone_number": "508-660-1666",
            "fax_number": "508-660-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASSELL",
        "first_name": "KRISTINA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "MA",
            "license": "2290360",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2021028901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walpole, MA

Sources for this page

Verify at the official NPI Registry.