Phuong Dang
Individual provider Active NPI Family Nurse Practitioner · Lowell, MA
NPI 1780133793 · NPPES record last updated Oct 3, 2016
Key facts
- NPI
- 1780133793
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN2287102 (MA)
- Practice address
- 161 Jackson St
Lowell, MA 01852-2103 - Phone
- (978) 441-1700
- NPI assigned
- Oct 3, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lowell Community Health Center, Inc.
Practice addresses (Care Compare)
161 Jackson St
Lowell, MA 01852-2103
Phone (978) 937-9700
Hospital & facility affiliations
- Lowell General Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170220001658 | MA | Practitioner - Nurse Practitioner | 1153604004 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lowell Community Health Center, Inc. | Current |
Accepting new patients | |
| Lowell Community Health Center, Inc. | Current |
Accepting new patients |
Locations
161 Jackson St
Lowell, MA 01852
Phone (978) 746-7867
101 Jackson St
Lowell, MA 01852
Phone (978) 459-8656
Interoperability endpoints
- pdang18994@direct.ctc.masshiway.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN2287102 | MA | Yes |
Addresses
Primary practice location
161 Jackson St
Lowell, MA 01852-2103
Mailing address
161 Jackson St
Lowell, MA 01852-2103
Phone (978) 441-1700
Other providers in Lowell, MA
- Madison Celeste Dallmeyer
- Ryan Nicholas Dandaraw
- Hamid Reza Danesh
- Mona Daneshi
- Loc Nhu Dang
- Robert Alan Daniels
- George Appiah Danquah
- John Dao-Tran
- Snehlata V Dave
- David C Morley Jr MD PC
All providers in Lowell, MA · Family Nurse Practitioner in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.