Individual provider Active NPI

Niki Thi Nguyen, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1538919618
Registry record updated Feb 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2302779 Issued in MA
Practice address
425 Lake Ave N Ste 101
Worcester, MA 01605-2073
Phone
(508) 753-3220
Fax
(508) 753-3224
NPI assigned
Mar 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2025

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 RN2302779 MA Primary

Addresses

Primary practice location

425 Lake Ave N Ste 101
Worcester, MA 01605-2073

Mailing address

425 Lake Ave N Ste 101
Worcester, MA 01605-2073
Phone (508) 753-3220

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
I20250207001481 MA Practitioner - Nurse Practitioner 4587194428 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
Group practices
Advanced Psych Services LLCGroup PAC ID 2961667498, 19 clinicians

Practice addresses (Care Compare)

425 Lake Ave N
Suite 101
Worcester, MA 01605-2073
Phone (508) 753-3220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2302779MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Psych Services, LLC CurrentSince Feb 2, 2025 Accepting new patients

Locations

425 Lake Ave N
Ste 101
Worcester, MA 01605
Phone (508) 753-3220

Organizations & group practices 1

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": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738454400000",
    "number": "1538919618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 LAKE AVE N STE 101",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052073",
            "telephone_number": "508-753-3220",
            "fax_number": "508-753-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 LAKE AVE N STE 101",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052073",
            "telephone_number": "508-753-3220",
            "fax_number": "508-753-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "NIKI",
        "middle_name": "THI",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2025-02-02",
        "certification_date": "2025-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2302779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.