Individual provider Active NPI

Henry Ntoro Sr.

  • Psychiatric/Mental Health Nurse Practitioner
  • Concord, MA
National Provider Identifier
1740635283
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2015020950 Issued in MA
Practice address
300 Baker Ave Ste 300
Concord, MA 01742-2124
Phone
(978) 627-3929
NPI assigned
May 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN064237-23 NH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2015020950 MA Primary

Addresses

Primary practice location

300 Baker Ave Ste 300
Concord, MA 01742-2124

Mailing address

300 Baker Ave Ste 300
Concord, MA 01742-2124

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
I20160909000229 MA Practitioner - Nurse Practitioner 4082900568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Henry Kengong Ntoro LLCGroup PAC ID 9537420195, 2 clinicians

Practice addresses (Care Compare)

300 Baker Ave
Suite 300
Concord, MA 01742-2124
Phone (978) 328-7650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2015020950MAMDPsychiatric/Mental Health Nurse Practitioner
APRN064237-23NHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Kengong Ntoro LLC CurrentSince Dec 23, 2017 Accepting new patients

Locations

300 Baker Ave
Ste 300
Concord, MA 01742
Phone (864) 336-2731

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.

NPI Registry JSON

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1740635283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BAKER AVE STE 300",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BAKER AVE STE 300",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422124",
            "telephone_number": "978-627-3929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NTORO",
        "first_name": "HENRY",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-03",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "APRN064237-23",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2015020950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

Verify at the official NPI Registry.