Individual provider Active NPI

Herman M Ainebyona

  • Psychiatric/Mental Health Nurse Practitioner
  • Marlborough, MA
National Provider Identifier
1730058009
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2331518 Issued in MA
Practice address
80 W Main St
Marlborough, MA 01752-5512
Phone
(857) 231-3739
NPI assigned
Nov 4, 2025
Last updated
Dec 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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 RN2331518 MA Primary

Addresses

Primary practice location

80 W Main St
Marlborough, MA 01752-5512

Mailing address

80 W Main St
Marlborough, MA 01752-5512

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
I20260105001932 MA Practitioner - Nurse Practitioner 0547756009 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Healthcare LLCGroup PAC ID 4880063726, 13 clinicians

Practice addresses (Care Compare)

81 Memorial Pkwy
Ofc a
Randolph, MA 02368-4505
Phone (781) 926-3339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2331518MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Healthcare LLC Psychiatric/Mental Health CurrentSince Dec 1, 2025 Accepting new patients
Yjr Group Inc Registered Nurse CurrentSince Nov 9, 2025 Accepting new patients

Locations

81 Memorial Pkwy
Ofc A
Randolph, MA 02368
Phone (781) 926-3339

Organizations & group practices 3

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": "1762214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1730058009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 W MAIN ST",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017525512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 W MAIN ST",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017525512",
            "telephone_number": "857-231-3739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AINEBYONA",
        "first_name": "HERMAN",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-04",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2331518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlborough, MA

Sources for this page

Verify at the official NPI Registry.