Avita Slopadoe

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2021119096 Issued in MA

Practice address

4 Longfellow LN Apt 102
Tyngsboro, MA 01879-2787

Phone

(978) 606-8429

NPI assigned

Sep 16, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Renaissance Primary Care LLCGroup PAC ID 3476832379, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Renaissance Primary Care, LLC

  • Internal Medicine Physician
  • Southbridge, MA
  • NPI 1649729021
  Medicare reassignment Care Compare group
• Blueprint Healthcare LLC

  • Internal Medicine Physician
  • Fitchburg, MA
  • NPI 1467927483
  Medicare reassignment NPD

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1669194536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 LONGFELLOW LN APT 102",
            "city": "TYNGSBORO",
            "state": "MA",
            "postal_code": "018792787",
            "telephone_number": "978-606-8429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 LONGFELLOW LN APT 102",
            "city": "TYNGSBORO",
            "state": "MA",
            "postal_code": "018792787",
            "telephone_number": "978-606-8429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOPADOE",
        "first_name": "AVITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "2021119096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tessa Ryan
• William Joseph Ryan III, O.D.
• Suzanna Samuel
• Jennifer Anne Schultz Bray, LMHC
• Thomas Joseph Sherriff
• Spaulding Hill Care
• Sudbury Vision Associates,Inc.
• Summit Group Inc
• Sunrise Community Support Services LLC
• Town of Tyngsborough

• Family Nurse Practitioner in Tyngsboro, MA
• Providers in Tyngsboro, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; 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.