Individual provider Active NPI

Mary Katherine Marcellus, CNP

  • Family Nurse Practitioner
  • Mashpee, MA
National Provider Identifier
1700662004
Registry record updated Sep 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2329432 Issued in MA
Practice address
195 Falmouth Rd Apt 8a
Mashpee, MA 02649-2683
Phone
(802) 384-2061
NPI assigned
Sep 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2329432 MA Primary

Addresses

Primary practice location

195 Falmouth Rd Apt 8a
Mashpee, MA 02649-2683

Mailing address

195 Falmouth Rd Apt 8a
Mashpee, MA 02649-2683
Phone (802) 384-2061

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
I20260226000327 MA Practitioner - Nurse Practitioner 3577044601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vantage Healthcare LLCGroup PAC ID 8224361191, 72 clinicians

Practice addresses (Care Compare)

12 Bluebird Rd
Wellesley, MA 02481-3503
Phone (774) 309-4129

Hospital & facility affiliations

  • Bayada Home Health Care Inc Home health agency, Plymouth, MA, CCN 227537

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2329432MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vantage Healthcare LLC CurrentSince Jan 19, 2026 Accepting new patients

Locations

45 Dan Rd
Canton, MA 02021
Phone (781) 318-3609

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1693785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1700662004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 FALMOUTH RD APT 8A",
            "city": "MASHPEE",
            "state": "MA",
            "postal_code": "026492683",
            "telephone_number": "802-384-2061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 FALMOUTH RD APT 8A",
            "city": "MASHPEE",
            "state": "MA",
            "postal_code": "026492683",
            "telephone_number": "802-384-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELLUS",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-04",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2329432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mashpee, MA

Sources for this page

Verify at the official NPI Registry.