Individual provider Active NPI

Esi Korsah, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Charlton, MA
National Provider Identifier
1679136436
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN264816 Issued in MA
Practice address
3 Sydney Cir
Charlton, MA 01507-1728
Phone
(774) 277-2512
NPI assigned
Apr 17, 2019
Last updated
Aug 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN264816 MA Primary
Registered Nurse 163W00000X RN264816 MA
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X RN264816 MA

Addresses

Primary practice location

3 Sydney Cir
Charlton, MA 01507-1728

Mailing address

3 Sydney Cir
Charlton, MA 01507-1728
Phone (774) 277-2512

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
I20221206001529 MA Practitioner - Nurse Practitioner 7618346164 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN264816MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
New England Hospitalists PC CurrentSince Jul 18, 2023 Accepting new patients
Tetra Behavioral Services PLLC CurrentSince Jan 1, 2025 Accepting new patients
Supportive Behavioral Care of Ma LLC CurrentSince Sep 20, 2022 Accepting new patients

Locations

44 School St
Rm 325
Boston, MA 02108
Phone (508) 831-8558

167 Washington St
Norwell, MA 02061
Phone (617) 686-9932

475 Pleasant St
Ste D
Worcester, MA 01609
Phone (508) 753-4151

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

27 Randolph Rd
#A
Howell, NJ 07731
Phone (732) 797-9290

Interoperability endpoints

  • Direct secure messaging: esi.korsah.1@22807.direct.athenahealth.com

Organizations & group practices 3

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": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1679136436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SYDNEY CIR",
            "city": "CHARLTON",
            "state": "MA",
            "postal_code": "015071728",
            "telephone_number": "774-277-2512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SYDNEY CIR",
            "city": "CHARLTON",
            "state": "MA",
            "postal_code": "015071728",
            "telephone_number": "774-277-2512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORSAH",
        "first_name": "ESI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-17",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN264816",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN264816",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "RN264816",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlton, MA

Sources for this page

Verify at the official NPI Registry.