Individual provider Active NPI

Pramila Mitnala Rao, AGNP-C

  • Gerontology Nurse Practitioner
  • Lowell, MA
National Provider Identifier
1548122823
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN2277904 Issued in MA
Practice address
161 Jackson St
Lowell, MA 01852-2103
Phone
(978) 937-9700
Fax
(978) 221-6728
NPI assigned
Nov 25, 2025
Last updated
May 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN2277904 MA Primary

Addresses

Primary practice location

161 Jackson St
Lowell, MA 01852-2103

Mailing address

4 Fischer Path
Acton, MA 01720-7756
Phone (978) 551-2621

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
I20260212002264 MA Practitioner - Nurse Practitioner 4082933726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

161 Jackson St
Lowell, MA 01852-2103
Phone (978) 937-9700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2277904MAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lowell Community Health Center, Inc. CurrentSince Mar 23, 2026 Accepting new patients
Lowell Community Health Center, Inc. Multi-Specialty CurrentSince Mar 23, 2026 Accepting new patients

Locations

101 Jackson St
Lowell, MA 01852
Phone (978) 459-8656

161 Jackson St
Lowell, MA 01852
Phone (978) 746-7867

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, 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": "1764028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1548122823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FISCHER PATH",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017207756",
            "telephone_number": "978-551-2621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 JACKSON ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018522103",
            "telephone_number": "978-937-9700",
            "fax_number": "978-221-6728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAO",
        "first_name": "PRAMILA",
        "middle_name": "MITNALA",
        "name_prefix": "Mrs.",
        "credential": "AGNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-25",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN2277904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.