Individual provider Active NPI

Mercy Kangai Micheni

  • Psychiatric/Mental Health Nurse Practitioner
  • Lowell, MA
National Provider Identifier
1588353049
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2331564 Issued in MA
Practice address
1400 Gorham St Apt 17
Lowell, MA 01852-5248
Phone
(978) 483-1125
Fax
(254) 566-2989
NPI assigned
May 2, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 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 RN2331564 MA Primary

Addresses

Primary practice location

1400 Gorham St Apt 17
Lowell, MA 01852-5248

Mailing address

1400 Gorham St Apt 17
Lowell, MA 01852-5248
Phone (978) 483-1125

Other practice location 1

300 Brickstone Sq Ste 201
Andover, MA 01810-1497
Phone (978) 237-0164

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
I20250702001793 MA Practitioner - Nurse Practitioner 0244743235 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
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1400 Gorham St
Apt 17
Lowell, MA 01852-5248
Phone (978) 483-1125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2331564MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adalia Wellness and Behavioral Services Psychiatric/Mental Health CurrentSince May 28, 2025 Accepting new patients

Locations

300 Brickstone Sq
Ste 201
Andover, MA 01810
Phone (978) 483-7515

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": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1588353049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 GORHAM ST APT 17",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018525248",
            "telephone_number": "978-483-1125",
            "fax_number": "254-566-2989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 GORHAM ST APT 17",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018525248",
            "telephone_number": "978-483-1125",
            "fax_number": "254-566-2989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Brickstone Sq Ste 201",
            "address_purpose": "LOCATION",
            "city": "Andover",
            "state": "MA",
            "postal_code": "018101497",
            "country_code": "US",
            "telephone_number": "978-237-0164",
            "fax_number": "254-566-2989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHENI",
        "first_name": "MERCY",
        "middle_name": "KANGAI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-02",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2331564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.