Individual provider Active NPI

Raymond Mwanje, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1801779749
Registry record updated Oct 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2293570 Issued in MA
Practice address
90 Canal St Ste 4
Boston, MA 02114-2022
Phone
(315) 873-2936
NPI assigned
Jul 29, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 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 RN2293570 MA Primary

Addresses

Primary practice location

90 Canal St Ste 4
Boston, MA 02114-2022

Mailing address

227 Chelmsford St Lowr Level
Chelmsford, MA 01824-2305
Phone (781) 488-7406

Other practice location 1

227 Chelmsford St Lowr Level
Chelmsford, MA 01824-2305
Phone (857) 272-0212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250910004228 MA Practitioner - Nurse Practitioner 6305349945 Reassigns benefits to 2 organizations
I20251124002121 NH Practitioner - Nurse Practitioner 6305349945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Supportive Behavioral Care of Ma LLCGroup PAC ID 8628346731, 103 clinicians

Practice addresses (Care Compare)

44 School St
RM 325
Boston, MA 02108-4209
Phone (718) 298-4375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thuja Health and Wellness, PLLC Psychiatric/Mental Health CurrentSince Nov 2, 2025 Accepting new patients
Supportive Behavioral Care of Ma LLC CurrentSince Sep 1, 2025 Accepting new patients
Supportive Care of New Hampshire LLC CurrentSince Nov 1, 2025 Accepting new patients

Locations

44 School St
Rm 325
Boston, MA 02108
Phone (508) 831-8558

227 Chelmsford St
Lowr
Chelmsford, MA 01824
Phone (781) 488-7406

20 Chester Rd
Derry, NH 03038
Phone (603) 432-3801

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1753747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760832000000",
    "number": "1801779749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 CHELMSFORD ST LOWR LEVEL",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018242305",
            "telephone_number": "781-488-7406",
            "fax_number": "800-887-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 CANAL ST STE 4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142022",
            "telephone_number": "315-873-2936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "227 Chelmsford St Lowr Level",
            "address_purpose": "LOCATION",
            "city": "Chelmsford",
            "state": "MA",
            "postal_code": "018242305",
            "country_code": "US",
            "telephone_number": "857-272-0212",
            "fax_number": "800-887-0802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MWANJE",
        "first_name": "RAYMOND",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-29",
        "last_updated": "2025-10-19",
        "certification_date": "2025-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2293570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.