Individual provider Active NPI

Allison Tavares, FNP-BC

  • Nurse Practitioner
  • Ludlow, MA
National Provider Identifier
1609501832
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2324048 Issued in MA
Practice address
471 Center St
Ludlow, MA 01056-2733
Phone
(413) 625-3500
NPI assigned
Jul 21, 2022
Last updated
Nov 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2324048 MA Primary

Addresses

Primary practice location

471 Center St
Ludlow, MA 01056-2733

Mailing address

360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700

Other names 1

  • Allison Anselmo Former name

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
I20221006000418 MA Practitioner - Nurse Practitioner 8729464268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
George Washington University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians

Practice addresses (Care Compare)

245 Hartford Ave
Bellingham, MA 02019-3007
Phone (774) 295-4355

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Convenientmd - FFS UC LLC Urgent Care CurrentSince Oct 7, 2023 Accepting new patients
Convenientmd - FFS UC LLC Urgent Care CurrentSince Oct 7, 2023 Accepting new patients
Convenientmd - FFS UC LLC Urgent Care Current Accepting new patients
Convenientmd - FFS UC LLC Urgent Care Past Accepting new patients
Convenientmd LLC Urgent Care Past Accepting new patients

Locations

245 Hartford Ave
Bellingham, MA 02019
Phone (774) 295-4355

40 Davis Straits
Falmouth, MA 02540
Phone (774) 255-3010

471 Center St
Ludlow, MA 01056
Phone (413) 625-3500

419 Andover St
#B
North Andover, MA 01845
Phone (978) 620-5040

111 New Hampshire Ave
Portsmouth, NH 03801

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

111 New Hampshire Ave
Ste 2
Portsmouth, NH 03801
Phone (603) 319-4490

Organizations & group practices 5

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": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1609501832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 CENTER ST",
            "city": "LUDLOW",
            "state": "MA",
            "postal_code": "010562733",
            "telephone_number": "413-625-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVARES",
        "first_name": "ALLISON",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2324048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLISON",
            "last_name": "ANSELMO",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ludlow, MA

Sources for this page

Verify at the official NPI Registry.