Individual provider Active NPI

Samantha Beaudoin, NP

  • Family Nurse Practitioner
  • East Longmeadow, MA
National Provider Identifier
1720648561
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2309104 Issued in MA
Practice address
250 N Main St
Ste 101
East Longmeadow, MA 01028-1834
Phone
(413) 525-1870
NPI assigned
Jun 14, 2019
Last updated
Apr 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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 RN2309104 MA Primary

Addresses

Primary practice location

250 N Main St
Ste 101
East Longmeadow, MA 01028-1834

Mailing address

42 Briere Dr
Chicopee, MA 01020-1138
Phone (413) 530-1254

Other practice location 1

575 Beech St
Holyoke, MA 01040
Phone (413) 534-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2309104MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Services of Springfield, Inc. CurrentSince Apr 13, 2025 Accepting new patients

Locations

250 N Main St
Ste 101
East Longmeadow, MA 01028
Phone (413) 525-1870

70 Post Office Park
Wilbraham, MA 01095
Phone (413) 598-7770

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/374254e6-8a71-4f61-90b5-064a630a4cd8/

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": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1720648561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 BRIERE DR",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010201138",
            "telephone_number": "413-530-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N MAIN ST",
            "address_2": "STE 101",
            "city": "EAST LONGMEADOW",
            "state": "MA",
            "postal_code": "010281834",
            "telephone_number": "413-525-1870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "575 Beech St",
            "address_purpose": "LOCATION",
            "city": "Holyoke",
            "state": "MA",
            "postal_code": "01040",
            "country_code": "US",
            "telephone_number": "413-534-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAUDOIN",
        "first_name": "SAMANTHA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2309104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Longmeadow, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.