Jude Gamanuel Adolphe Sr.
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Brockton, MA
NPI 1700550217 · NPPES record last updated Jan 3, 2024
Key facts
- NPI
- 1700550217
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- RN2324231 (MA)
- Practice address
- 30 Meadowbrook Rd
Brockton, MA 02301-7122 - Phone
- (508) 659-5069
- NPI assigned
- Aug 7, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- High Point Treatment Center Inc
Supportive Behavioral Care of Ma LLC
Practice addresses (Care Compare)
10 Meadowbrook Rd
Brockton, MA 02301-7122
Phone (508) 742-4400
44 School St
RM 325
Boston, MA 02108-4209
Phone (718) 298-4375
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.67 of 100
- Quality
- 71.18
- Improvement activities
- 40
- Cost
- 75.07
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211129001730 | MA | Practitioner - Nurse Practitioner | 1254721673 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| High Point Treatment Center Inc. | Current |
Accepting new patients | |
| Supportive Behavioral Care of Ma LLC | Current |
Accepting new patients |
Locations
44 School St
Rm 325
Boston, MA 02108
Phone (508) 831-8558
10 Meadowbrook Rd
Brockton, MA 02301
Phone (508) 584-9210
30 Meadowbrook Rd
Brockton, MA 02301
Phone (508) 408-6190
108 N Front St
New Bedford, MA 02740
Phone (508) 689-5576
68 N Front St
New Bedford, MA 02740
Phone (508) 689-5576
72 Kilburn St
New Bedford, MA 02740
Phone (774) 213-8448
61 Industrial Park Rd
Plymouth, MA 02360
Phone (508) 746-8977
1233 State Rd
Plymouth, MA 02360
Phone (508) 224-6527
27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | RN2324231 | MA | Yes |
Addresses
Primary practice location
30 Meadowbrook Rd
Brockton, MA 02301-7122
Mailing address
30 Meadowbrook Rd
Brockton, MA 02301-7122
Phone (508) 659-5069
Other providers in Brockton, MA
- Stephen R. Addington
- Dorcas Oyebisi Adeniyi
- Melissa C Lee Adigun
- Valerie Rachelle Adjorlolo
- Richard Patrick Adkins
- Adult Day Health, Inc.
- Adult Day Health, Inc.
- Adult Day Health, Inc.
- Advanced Gastrointestinal & General Surgical Healthcare, LLC
- Ranu Aeron
All providers in Brockton, MA · Psychiatric/Mental Health Nurse Practitioner in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.