Individual provider Active NPI

Roberta J Compagna, ARNP

  • Family Nurse Practitioner
  • Dover, NH
National Provider Identifier
1669652301
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
039674-23 Issued in NH
Practice address
10 Members Way Ste 203
Dover, NH 03820
Phone
(603) 742-3174
Fax
(603) 742-1855
NPI assigned
Nov 9, 2007
Last updated
Aug 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 039674-23 NH Primary

Addresses

Primary practice location

10 Members Way Ste 203
Dover, NH 03820

Mailing address

789 Central Ave
Dover, NH 03820-2526
Phone (603) 742-3174

Other identifiers 1

IdentifierTypeStateIssuer
3072086MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, ME2 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
I20080401000274 NH Practitioner - Nurse Practitioner 1052497039 Reassigns benefits to 1 organization
I20200807000047 ME Practitioner - Nurse Practitioner 1052497039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

31 Colcord St
South Berwick, ME 03908-1004
Phone (207) 384-4949

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
039674-23NHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Hospital Current Accepting new patients
Catholic Medical Center CurrentSince Jun 14, 2012 Accepting new patients
Wentworth Douglass Hospital Past Accepting new patients

Locations

5 Washington Pl
Ste 1A
Bedford, NH 03110
Phone (603) 663-8060

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

195 McGregor St
Ste 310
Manchester, NH 03102

57 Webster St
Manchester, NH 03104
Phone (603) 622-6491

775 S Main St
Manchester, NH 03102
Phone (603) 625-6198

Interoperability endpoints

  • Direct secure messaging: compagna.roberta.wdh@direct.partners.masshiway.net

Organizations & group practices 4

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": "1194566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1669652301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-742-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MEMBERS WAY STE 203",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "03820",
            "telephone_number": "603-742-3174",
            "fax_number": "603-742-1855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMPAGNA",
        "first_name": "ROBERTA",
        "middle_name": "J",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-09",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "039674-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3072086",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.