Individual provider Active NPI

Adaeze Nwanegbo

  • Psychiatric/Mental Health Nurse Practitioner
  • Middleboro, MA
National Provider Identifier
1578258810
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2276370 Issued in MA
Practice address
94 S Main St
Middleboro, MA 02346-2123
Phone
(774) 373-2408
NPI assigned
Apr 11, 2023
Last updated
May 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2276370 MA Primary
Case Management Registered Nurse 163WC0400X RN2276370 MA

Addresses

Primary practice location

94 S Main St
Middleboro, MA 02346-2123

Mailing address

7 Desiderata Dr
Plymouth, MA 02360-6879
Phone (617) 875-2870

Other practice location 1

7 Desiderata Dr
Plymouth, MA 02360-6879
Phone (617) 875-2870

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
I20230621000410 MA Practitioner - Nurse Practitioner 2961860168 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

94 S Main St
Middleboro, MA 02346-2123
Phone (508) 947-6100

Merit-based Incentive Payment System (MIPS)

Final score
86.67 of 100Reported as group
Quality
71.18
Improvement activities
40
Cost
75.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Health Services, LLC CurrentSince Nov 1, 2023 Accepting new patients
Supportive Behavioral Care of Ma LLC CurrentSince Jun 1, 2023 Accepting new patients

Locations

44 School St
Rm 325
Boston, MA 02108
Phone (508) 831-8558

94 S Main St
Middleboro, MA 02346
Phone (508) 504-8988

30 Taunton Grn
Ste 5
Taunton, MA 02780
Phone (508) 545-7400

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

27 Randolph Rd
#A
Howell, NJ 07731
Phone (732) 797-9290

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1578258810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DESIDERATA DR",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023606879",
            "telephone_number": "617-875-2870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 S MAIN ST",
            "city": "MIDDLEBORO",
            "state": "MA",
            "postal_code": "023462123",
            "telephone_number": "774-373-2408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Desiderata Dr",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MA",
            "postal_code": "023606879",
            "country_code": "US",
            "telephone_number": "617-875-2870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWANEGBO",
        "first_name": "ADAEZE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-11",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2276370",
            "primary": true
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "MA",
            "license": "RN2276370",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleboro, MA

Sources for this page

Verify at the official NPI Registry.