Individual provider Active NPI

Emmanuel D Resendes, ANP-BC

  • Nurse Practitioner
  • Fall River, MA
National Provider Identifier
1649575846
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN255969 Issued in MA
Practice address
300 Hanover St Ste 2a
Fall River, MA 02720-5451
Phone
(508) 973-7774
Fax
(508) 973-7724
NPI assigned
Jan 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN01531 RI
Nurse Practitioner 363L00000X RN255969 MA Primary

Addresses

Primary practice location

300 Hanover St Ste 2a
Fall River, MA 02720-5451

Mailing address

200 Mill Road
Suite 180
Fairhaven, MA 02719
Phone (508) 973-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eresendes6279@direct.southcoast.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141029000500 MA Practitioner - Nurse Practitioner 6305067703 Reassigns benefits to 2 organizations
I20170601002241 RI Practitioner - Nurse Practitioner 6305067703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

1076 N Main St
Southcoast Physicians Services Inc
Providence, RI 02904-5709
Phone (401) 273-2460

363 Highland Ave
Fall River, MA 02720-3703
Phone (508) 973-5919

534 Prospect St
Fall River, MA 02720-5281
Phone (508) 973-7766

Hospital & facility affiliations

  • Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN255969MAMDNurse Practitioner
APRN01531RIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Hospitals Group, Inc CurrentSince Apr 8, 2017 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Jan 1, 2014 Accepting new patients
Southcoast Hospitals Group Inc CurrentSince Apr 8, 2017 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Jan 1, 2014 Accepting new patients
Southcoast Hospitals Group, Inc Current Accepting new patients

Locations

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

300 Hanover St
Ste 2A
Fall River, MA 02720
Phone (508) 973-7774

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

874 Purchase St
New Bedford, MA 02740
Phone (508) 992-6553

11 Friendship St
Newport, RI 02840
Phone (401) 845-1110

1076 N Main St
Providence, RI 02904
Phone (401) 273-2460

Interoperability endpoints

  • Direct secure messaging: eresendes6279@direct.southcoast.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1295395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1649575846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL ROAD",
            "address_2": "SUITE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "02719",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HANOVER ST STE 2A",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027205451",
            "telephone_number": "508-973-7774",
            "fax_number": "508-973-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESENDES",
        "first_name": "EMMANUEL",
        "middle_name": "D",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-19",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN01531",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN255969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eresendes6279@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "300 Hanover St Ste 2A",
            "city": "Fall River",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027205451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.