Individual provider Active NPI

Brianna Susan Soares

  • Family Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1669997615
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2306075 Issued in MA
Practice address
26 Queen Street
Worcester, MA 01610-2473
Phone
(508) 860-7800
Fax
(508) 860-7855
NPI assigned
Aug 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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 RN2306075 MA Primary

Addresses

Primary practice location

26 Queen Street
Worcester, MA 01610-2473

Mailing address

26 Queen St
Worcester, MA 01610-2473
Phone (508) 860-7800

Other names 1

  • Brianna Susan Hayes Former name

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
I20171005000856 MA Practitioner - Nurse Practitioner 7911272679 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Center of Worcester, Inc. CurrentSince Sep 25, 2017 Accepting new patients
Family Health Center of Worcester, Inc. CurrentSince Sep 25, 2017 Accepting new patients
Total Wellness Centers, LLC CurrentSince May 1, 2022 Accepting new patients
Afc Physicians of Massachusetts, PC CurrentSince Oct 1, 2021 Accepting new patients
DRX UC Worcester PC CurrentSince Oct 1, 2021 Accepting new patients
Total Wellness Centers, LLC CurrentSince May 1, 2022 Accepting new patients

Locations

360 Merrimack St
Lawrence, MA 01843
Phone (978) 557-8800

165 Mill St
Unit 2
Leominster, MA 01453
Phone (978) 227-1046

900 Memorial Ave
West Springfield, MA 01089
Phone (413) 739-9001

26 Queen St
Worcester, MA 01610
Phone (508) 860-7700

117 Stafford St
Ste A
Worcester, MA 01603
Phone (508) 755-4010

Interoperability endpoints

  • Direct secure messaging: bhayes47756@direct.ctc.masshiway.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1669997615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 QUEEN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102473",
            "telephone_number": "508-860-7800",
            "fax_number": "508-860-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 QUEEN STREET",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102473",
            "telephone_number": "508-860-7800",
            "fax_number": "508-860-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOARES",
        "first_name": "BRIANNA",
        "middle_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-11",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2306075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIANNA",
            "last_name": "HAYES",
            "middle_name": "SUSAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.