Individual provider Active NPI

Christine Dale Raucci, APRN-BC, CNS

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Danvers, MA
National Provider Identifier
1598711780
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
125049 Issued in MA
Practice address
85 Constitution LN
Suite 300a
Danvers, MA 01923-3694
Phone
(978) 750-0755
Fax
(978) 750-0766
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 125049 MA Primary

Addresses

Primary practice location

85 Constitution LN
Suite 300a
Danvers, MA 01923-3694

Mailing address

85 Constitution LN
Suite 300a
Danvers, MA 01923-3694
Phone (978) 750-0755

Other identifiers 1

IdentifierTypeStateIssuer
NP2441OtherMABC/BS NP PROVIDER

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
I20060606000230 MA Practitioner - Certified Clinical Nurse Specialist (CNS) 4789695867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore Nurse Practitioner Associates LLCGroup PAC ID 5395800924, 3 clinicians

Practice addresses (Care Compare)

85 Constitution LN
300A
Danvers, MA 01923-3694
Phone (978) 750-0755

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
125049MAMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Nurse Practitioner Associates, LLC Psychiatric/Mental Health, Adult CurrentSince Jan 29, 2009 Accepting new patients
Nutritious Measures Inc PastSince Aug 23, 2020 Accepting new patients

Locations

85 Constitution Ln
Ste 300A
Danvers, MA 01923
Phone (978) 750-0755

85 Constitution Ln
#300A
Danvers, MA 01923
Phone (978) 626-1105

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1598711780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 CONSTITUTION LN",
            "address_2": "SUITE 300A",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233694",
            "telephone_number": "978-750-0755",
            "fax_number": "978-750-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 CONSTITUTION LN",
            "address_2": "SUITE 300A",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233694",
            "telephone_number": "978-750-0755",
            "fax_number": "978-750-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUCCI",
        "first_name": "CHRISTINE",
        "middle_name": "DALE",
        "credential": "APRN-BC, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "125049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS NP PROVIDER",
            "identifier": "NP2441",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

Verify at the official NPI Registry.