Individual provider Active NPI

Elizabeth Marie Scamperle, PMHNP

  • Nurse Practitioner
  • Braintree, MA
National Provider Identifier
1659994234
Registry record updated Apr 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN209754 Issued in MA
Practice address
1501 Washington St FL 2
Braintree, MA 02184-7599
Phone
(617) 847-1909
Fax
(781) 843-2418
NPI assigned
May 18, 2020
Last updated
Apr 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN209754 MA Primary

Addresses

Primary practice location

1501 Washington St FL 2
Braintree, MA 02184-7599

Mailing address

1501 Washington St FL 2
Braintree, MA 02184-7599
Phone (617) 847-1909

Other practice location 1

64 Industrial Park Rd
Plymouth, MA 02360-4881
Phone (617) 847-1909

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
I20230321000200 MA Practitioner - Nurse Practitioner 5294109997 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Mental Health Center, Inc. CurrentSince Nov 23, 2022 Accepting new patients

Locations

1501 Washington St
Braintree, MA 02184
Phone (617) 745-2709

1501 Washington St
Fl 2
Braintree, MA 02184
Phone (617) 847-1909

64 Industrial Park Rd
Plymouth, MA 02360
Phone (508) 747-2012

500 Victory Rd
Quincy, MA 02171
Phone (617) 774-1040

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680307200000",
    "number": "1659994234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 WASHINGTON ST FL 2",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021847599",
            "telephone_number": "617-847-1909",
            "fax_number": "781-843-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 WASHINGTON ST FL 2",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021847599",
            "telephone_number": "617-847-1909",
            "fax_number": "781-843-2418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "64 Industrial Park Rd",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MA",
            "postal_code": "023604881",
            "country_code": "US",
            "telephone_number": "617-847-1909",
            "fax_number": "781-843-2418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCAMPERLE",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-18",
        "last_updated": "2023-04-01",
        "certification_date": "2023-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN209754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Braintree, MA

Sources for this page

Verify at the official NPI Registry.