Active NPI
Sudeep GC
- Psychiatric/Mental Health Nurse Practitioner
- Brockton, MA
National Provider Identifier
1740082007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 2278501
- Practice address
- 940 Belmont St BLDG 2
Brockton, MA 02301-5596 - Phone
- (774) 826-2079
- NPI assigned
- Mar 26, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 2278501 | MA | Primary |
Addresses
Primary practice location
940 Belmont St BLDG 2
Brockton, MA 02301-5596
Mailing address
133 Taylor St
Malden, MA 02148-8021
Phone (205) 413-0878
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
11001 Executive Ctr Dr
Suite 200
Little Rock, AR 72211-4393
451 Andover St
Suite 206a
North Andover, MA 01845-5044
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2278501 | MA | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742947200000",
"number": "1740082007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "133 TAYLOR ST",
"city": "MALDEN",
"state": "MA",
"postal_code": "021488021",
"telephone_number": "205-413-0878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 BELMONT ST BLDG 2",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023015596",
"telephone_number": "774-826-2079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GC",
"first_name": "SUDEEP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-03-26",
"last_updated": "2025-03-26",
"certification_date": "2025-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MA",
"license": "2278501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.