Mary Poulias Mitchell, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN2280889 Issued in MA

Practice address

64 Boyden Rd
Holden, MA 01520-2570

Phone

(508) 829-6765

Fax

(978) 840-1680

NPI assigned

Sep 30, 2016

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

Other names 1

• Mary L. Poulias Former name

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.mitchell.npi1639628753.reliant@direct.optumcare.masshiway.net

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.

• Reliant Medical Group, Inc

  • Family Medicine Physician
  • Worcester, MA
  • NPI 1720017528

  MA

  Medicare reassignment Care Compare group NPD
• Grace Riley Integrative Psychiatry, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Worcester, MA
  • NPI 1356228969

  Family

  NPD Authorized official
• Reliant Medical Group, Inc

  • Physical Therapist
  • Worcester, MA
  • NPI 1295827962
  Care Compare group

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1639628753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714",
            "telephone_number": "508-368-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 BOYDEN RD",
            "city": "HOLDEN",
            "state": "MA",
            "postal_code": "015202570",
            "telephone_number": "508-829-6765",
            "fax_number": "978-840-1680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Grace Riley Aesthetics",
            "address_2": "409 Shrewsbury Street",
            "address_purpose": "LOCATION",
            "city": "worcester",
            "state": "MA",
            "postal_code": "01604",
            "country_code": "US",
            "telephone_number": "508-508-7965",
            "fax_number": "833-635-6680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MARY",
        "middle_name": "POULIAS",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-30",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2280889",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2280889",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "POULIAS",
            "middle_name": "L.",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mia L. Carbone & Associates, LLC. Psychotherapy & Wellness Practice
• Edward J Michalowski, DMD PC
• Catherine Waceke Migwi
• Alyssa Miller
• Mindwell Therapies, LLC
• Matthew Philip Moreno, AU.D.
• Mulroy Family Dental PC
• Kritsa Myers, M.S., BCBA
• Jennifer Nappila-Nutter, LMHC
• Neal M Novack DMD Inc. PC

• All providers in Holden, MA
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2026; 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.