Individual provider Active NPI

Phoebe Theresa Peal, FNP

  • Family Nurse Practitioner
  • Concord, MA
National Provider Identifier
1649904376
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2355187 Issued in MA
Practice address
133 Ornac
Concord, MA 01742-4159
Phone
(978) 287-1400
NPI assigned
Jul 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 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 RN2355187 MA
Family Nurse Practitioner 363LF0000X RN2355187 MA Primary

Addresses

Primary practice location

133 Ornac
Concord, MA 01742-4159

Mailing address

434 McGrath Hwy Apt 214
Somerville, MA 02143-2165
Phone (508) 738-1100

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
I20231130002313 MA Practitioner - Nurse Practitioner 1456709476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emerson Practice Associates, IncGroup PAC ID 8123188117, 247 clinicians

Practice addresses (Care Compare)

55 N Rd
Suite 120
Bedford, MA 01730-1078
Phone (339) 215-5100

Hospital & facility affiliations

  • Emerson Hospital - Hospital, W Concord, MA, CCN 220084

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2355187MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Emerson Practice Associates, Inc. CurrentSince Oct 21, 2023 Accepting new patients

Locations

55 North Rd
Ste 120
Bedford, MA 01730
Phone (339) 215-5100

62 13th St
Charlestown, MA 02129
Phone (617) 724-4260

133 Ornac
Concord, MA 01742
Phone (978) 287-3000

54 Baker Avenue Ext
Ste 101
Concord, MA 01742
Phone (978) 287-3532

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.

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": "1657324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1649904376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 MCGRATH HWY APT 214",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021432165",
            "telephone_number": "508-738-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 ORNAC",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017424159",
            "telephone_number": "978-287-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEAL",
        "first_name": "PHOEBE",
        "middle_name": "THERESA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-09",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2355187",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2355187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

Verify at the official NPI Registry.