Individual provider Active NPI

Stella Athanasopoulos, MSN, RN, CNP, FNP-BC

  • Family Nurse Practitioner
  • Dorchester, MA
National Provider Identifier
1811506397
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2334929 Issued in MA
Practice address
632 Blue Hill Ave
Dorchester, MA 02121-3293
Phone
(617) 825-3400
NPI assigned
Jul 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2334929 MA Primary

Addresses

Primary practice location

632 Blue Hill Ave
Dorchester, MA 02121-3293

Mailing address

9 Bowley Ave
Lynn, MA 01905-1802
Phone (978) 335-1058

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
I20230919001120 MA Practitioner - Nurse Practitioner 1850755232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates, Inc.Group PAC ID 6002946928, 155 clinicians

Practice addresses (Care Compare)

25 Marston St
Suite 301
Lawrence, MA 01841-2358
Phone (978) 946-8550

Hospital & facility affiliations

  • Merrimack Health Lawrence Hospital Hospital, Lawrence, MA, CCN 220010
  • Holy Family Hospital Hospital, Methuen, MA, CCN 220080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN2334929MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Pioneer Health Medical PLLC PastSince Nov 7, 2025 Accepting new patients

Locations

25 Marston St
Ste 301
Lawrence, MA 01841
Phone (978) 946-8230

1 General St
Lawrence, MA 01841
Phone (978) 946-8103

575 Turnpike St
Ste 22
North Andover, MA 01845
Phone (973) 975-9793

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1811506397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BOWLEY AVE",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019051802",
            "telephone_number": "978-335-1058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 BLUE HILL AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021213293",
            "telephone_number": "617-825-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATHANASOPOULOS",
        "first_name": "STELLA",
        "credential": "MSN, RN, CNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2334929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

Verify at the official NPI Registry.