Rosette Wakanabo, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN2320331 Issued in MA

Practice address

3214 Main Campus Dr
Lexington, MA 02421-8627

Phone

(508) 371-8503

NPI assigned

Nov 28, 2022

Last updated

Feb 24, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Supportive Behavioral Care of Ma LLCGroup PAC ID 8628346731, 103 clinicians

Bridgecare Provider Group Ma, PLLCGroup PAC ID 9638675762, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

Practice roles

Locations

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.

• Bridgecare Provider Group Ma, PLLC

  • Nurse Practitioner
  • Concord, MA
  • NPI 1679366298
  Medicare reassignment Care Compare group NPD
• New Leaf Behavioral Health, LLC

  • Nurse Practitioner
  • Waltham, MA
  • NPI 1053275693
  Medicare reassignment NPD Authorized official
• Supportive Behavioral Care of Ma LLC

  • Clinical Psychologist
  • Needham, MA
  • NPI 1780115519
  Medicare reassignment Care Compare group NPD
• Devens Treatment & Recovery Center, LLC

  dba Taravista Behavioral Health

  • Psychiatry Physician
  • Devens, MA
  • NPI 1811473267

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Maestro Medical Group, PLLC

  • Adult Medicine Physician
  • Holliston, MA
  • NPI 1275367591
  Medicare reassignment
• Caritas Health Care Services LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Richmond, TX
  • NPI 1629799077
  Authorized official Same address or phone
• Caritas Health Care Services LLC

  • Community/Behavioral Health Agency
  • Richmond, TX
  • NPI 1932820404
  Authorized official Same address or phone

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

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1629788906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3214 MAIN CAMPUS DR",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024218627",
            "telephone_number": "508-371-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3214 MAIN CAMPUS DR",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024218627",
            "telephone_number": "508-371-8503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKANABO",
        "first_name": "ROSETTE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-28",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2320331",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2320331",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Von Ferstel
• Agnieszka Von Grotthuss
• Andrew Vonderheide
• Hilde Waerstad, MSPT
• Sarah Marie Wahlen
• Jane Lori Waldman, PSYD
• Walgreen Eastern Co Inc (Walgreens #01863)
• Elisabeth Neelon Wallace, LICSW
• Wallis Dental LLC
• Regina Walsh Troast

• Psychiatric/Mental Health Nurse Practitioner in Lexington, MA
• Providers in Lexington, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.