NPIMap

Organization Active NPI

Nie Health Inc

  • Health Service Clinic/Center
  • Beverly, MA
National Provider Identifier
1689398786
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
NIE HEALTH INC
Practice address
100 Cummings Ctr Ste 235C
Beverly, MA 01915-6126
Phone
(978) 922-0088
Fax
(978) 922-0422
NPI assigned
Oct 3, 2022
Last updated
Oct 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Authorized official

Name
Iddy Mtango
Title
Director of Business Development
Phone
(978) 922-0088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

100 Cummings Ctr Ste 235C
Beverly, MA 01915-6126

Mailing address

100 Cummings Ctr Ste 235C
Beverly, MA 01915-6126
Phone (978) 922-0088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240402000891 MA Part B Supplier - Clinic/Group Practice 0446698039 Receives reassigned benefits from 8 practitioners
Practice locations: Beverly, MA

National Provider Directory

National Provider Directory

Locations

100 Cummings Ctr
Ste 204G
Beverly, MA 01915
Phone (978) 993-1988

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664755200000",
    "number": "1689398786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR STE 235C",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156126",
            "telephone_number": "978-922-0088",
            "fax_number": "978-922-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR STE 235C",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156126",
            "telephone_number": "978-922-0088",
            "fax_number": "978-922-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIE HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-02",
        "status": "A",
        "authorized_official_last_name": "MTANGO",
        "authorized_official_first_name": "IDDY",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "978-922-0088"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.