Individual provider Active NPI

Sulamithe Ndjike Tchandji

  • Psychiatric/Mental Health Nurse Practitioner
  • Brockton, MA
National Provider Identifier
1629797667
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2300096 Issued in MA
Practice address
940 Belmont St
Brockton, MA 02301-5596
Phone
(508) 583-4500
NPI assigned
Aug 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2300096 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2300096 MA Primary

Addresses

Primary practice location

940 Belmont St
Brockton, MA 02301-5596

Mailing address

40 Mediterranean Dr Apt 29
Weymouth, MA 02188-3811
Phone (781) 534-4659

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
I20230406001587 MA Practitioner - Nurse Practitioner 8123493038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthdrive Behavioral Health Services, PLLCGroup PAC ID 8729345822, 89 clinicians

Practice addresses (Care Compare)

100 Crossing Blvd
Suite 300
Framingham, MA 01702-5555
Phone (888) 964-6681

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthdrive Behavioral Health Services, PLLC Psychiatric/Mental Health CurrentSince Apr 3, 2023 Accepting new patients

Locations

100 Crossing Blvd
Ste 300
Framingham, MA 01702
Phone (857) 255-0486

Organizations & group practices 1

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": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1629797667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MEDITERRANEAN DR APT 29",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021883811",
            "telephone_number": "781-534-4659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 BELMONT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015596",
            "telephone_number": "508-583-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TCHANDJI",
        "first_name": "SULAMITHE",
        "middle_name": "NDJIKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2300096",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2300096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.