Individual provider Active NPI

Marie Rose Canton, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Dorchester, MA
National Provider Identifier
1609018837
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN235988 Issued in MA
Practice address
51 Neponset Ave
Dorchester, MA 02122-3321
Phone
(857) 598-4774
Fax
(857) 598-4816
NPI assigned
Apr 2, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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 RN235988 MA Primary

Addresses

Primary practice location

51 Neponset Ave
Dorchester, MA 02122-3321

Mailing address

51 Neponset Ave
Dorchester, MA 02122-3321
Phone (857) 598-4774

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
I20230109000892 MA Practitioner - Nurse Practitioner 3577615053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Priority Professional Care, LLCGroup PAC ID 4688726169, 2 clinicians

Practice addresses (Care Compare)

51 Neponset Ave
Dorchester, MA 02122-3321
Phone (857) 598-4774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN235988MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Priority Tender Care LLC Current Accepting new patients
Priority Professional Care, LLC CurrentSince Apr 5, 2016 Accepting new patients
Priority Professional Care,LLC Past Accepting new patients

Locations

51 Neponset Ave
Dorchester, MA 02122
Phone (617) 368-0820

1613 Blue Hill Ave
Ste 302
Mattapan, MA 02126
Phone (857) 598-4774

Interoperability endpoints

  • Direct secure messaging: priorityprofessionalcare.marierosecanton@160977.advancedmd-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1238630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1609018837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 NEPONSET AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021223321",
            "telephone_number": "857-598-4774",
            "fax_number": "857-598-4816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 NEPONSET AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021223321",
            "telephone_number": "857-598-4774",
            "fax_number": "857-598-4816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTON",
        "first_name": "MARIE",
        "middle_name": "ROSE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-02",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN235988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

Verify at the official NPI Registry.