Active NPI
Michaela Essam-Agbesi, NP
- Nurse Practitioner
- Worcester, MA
National Provider Identifier
1699907667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN267951
- Practice address
- 55 Lake Ave N
Worcester, MA 01655 - Phone
- (508) 334-8630
- Fax
- (774) 441-6710
- NPI assigned
- Aug 10, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | RN267951 | MA | |
| Nurse Practitioner | 363L00000X | RN267951 | MA | Primary |
Addresses
Primary practice location
55 Lake Ave N
Worcester, MA 01655
Mailing address
PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885
Other practice location 1
41 Mall Rd
Lahey Clinic, Inc.
Burlington, MA 01805-0001
Phone (781) 744-3839
Other practice location 2
119 Belmont St
Worcester, MA 01605-2903
Phone (508) 334-8630
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110084431A | Medicaid | MA |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | messamagbesi241890@UmassMemorial.direct-ci.com | ||
| FHIR URL | https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Interoperability endpoints
- messamagbesi@landmarkhealth-direct.org
- messamagbesi241890@umassmemorial.direct-ci.com
- michaela.essam-agbesi.1@27127.direct.athenahealth.com
- messamagbesi13085@direct.bilh.masshiway.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616716800000",
"number": "1699907667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 415348",
"city": "BOSTON",
"state": "MA",
"postal_code": "022415348",
"telephone_number": "800-225-8885",
"fax_number": "508-334-1977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 LAKE AVE N",
"city": "WORCESTER",
"state": "MA",
"postal_code": "01655",
"telephone_number": "508-334-8630",
"fax_number": "774-441-6710"
}
],
"practiceLocations": [
{
"address_1": "41 Mall Rd",
"address_2": "Lahey Clinic, Inc.",
"address_purpose": "LOCATION",
"city": "Burlington",
"state": "MA",
"postal_code": "018050001",
"country_code": "US",
"telephone_number": "781-744-3839",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "119 Belmont St",
"address_purpose": "LOCATION",
"city": "Worcester",
"state": "MA",
"postal_code": "016052903",
"country_code": "US",
"telephone_number": "508-334-8630",
"fax_number": "774-441-6710",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ESSAM-AGBESI",
"first_name": "MICHAELA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-10",
"last_updated": "2021-03-26",
"certification_date": "2021-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "MA",
"license": "RN267951",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "RN267951",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110084431A",
"state": "MA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "messamagbesi241890@UmassMemorial.direct-ci.com",
"affiliation": "N",
"address_1": "55 Lake Ave N",
"city": "Worcester",
"state": "MA",
"country_code": "US",
"postal_code": "01655",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "55 Lake Ave N",
"city": "Worcester",
"state": "MA",
"country_code": "US",
"postal_code": "01655",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.