Individual provider Active NPI

Melissa Robin Plourde, ANP

  • Nurse Practitioner
  • Waltham, MA
National Provider Identifier
1629234943
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
232592 Issued in MA
Practice address
950 Winter St
Waltham, MA 02451-1424
Phone
(413) 977-6083
Fax
(781) 419-8479
NPI assigned
Aug 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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 232592 MA Primary

Addresses

Primary practice location

950 Winter St
Waltham, MA 02451-1424

Mailing address

950 Winter St
Waltham, MA 02451-1424
Phone (413) 977-6083

Other names 1

  • Melissa Robin Ventrice 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
I20150423001537 MA Order and Referring Only - Nurse Practitioner 9537217419

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
232592MAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1629234943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 WINTER ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511424",
            "telephone_number": "413-977-6083",
            "fax_number": "781-419-8479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 WINTER ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511424",
            "telephone_number": "413-977-6083",
            "fax_number": "781-419-8479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOURDE",
        "first_name": "MELISSA",
        "middle_name": "ROBIN",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-06",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "232592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "VENTRICE",
            "middle_name": "ROBIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.