Individual provider Active NPI

Michele Pady-Moise, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Randolph, MA
National Provider Identifier
1700610417
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2263453 Issued in MA
Practice address
3 Virginia Cir
Randolph, MA 02368-5151
Phone
(617) 462-6734
Fax
(781) 963-8992
NPI assigned
Aug 27, 2024
Last updated
Aug 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2263453 MA Primary

Addresses

Primary practice location

3 Virginia Cir
Randolph, MA 02368-5151

Mailing address

3 Virginia Cir
Randolph, MA 02368-5151
Phone (617) 462-6734

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
I20260225002291 MA Practitioner - Nurse Practitioner 1254812480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

27 Randolph Rd
Howell, NJ 07731-8611

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2263453MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Behavioral Care of Ma LLC CurrentSince Jan 19, 2026 Accepting new patients

Locations

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

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

Organizations & group practices 1

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": "1724716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1700610417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 VIRGINIA CIR",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023685151",
            "telephone_number": "617-462-6734",
            "fax_number": "781-963-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 VIRGINIA CIR",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023685151",
            "telephone_number": "617-462-6734",
            "fax_number": "781-963-8992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADY-MOISE",
        "first_name": "MICHELE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-27",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2263453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, MA

Sources for this page

Verify at the official NPI Registry.