Individual provider Active NPI

Eleftheria Tsavoussis, PMHCNS-BC

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Waltham, MA
National Provider Identifier
1821073586
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
175264 Issued in MA
Practice address
210 Bear Hill Road
Suite 202
Waltham, MA 02451
Phone
(781) 966-0070
Fax
(781) 915-0755
NPI assigned
Dec 14, 2005
Last updated
Jul 31, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 175264 MA
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 175264 MA Primary

Addresses

Primary practice location

210 Bear Hill Road
Suite 202
Waltham, MA 02451

Mailing address

210 Bear Hill Road
Suite 202
Waltham, MA 02451
Phone (781) 966-0070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 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
I20050727000642 MA Practitioner - Nurse Practitioner 7012945595
I20160909001224 MA Practitioner - Certified Clinical Nurse Specialist (CNS) 7012945595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Boston University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Waltham Behavioral Health LLCGroup PAC ID 7315233822, 8 clinicians

Practice addresses (Care Compare)

210 Bear Hill Rd
Waltham, MA 02451-1025
Phone (781) 966-0070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
175264MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neurobehavioral Associates III, Inc Psychiatric/Mental Health, Adult PastSince May 25, 1999 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: walthambehavioralhealth.eleftheriatsavoussis@130601.advancedmd-direct.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1821073586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 BEAR HILL ROAD",
            "address_2": "SUITE 202",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "02451",
            "telephone_number": "781-966-0070",
            "fax_number": "781-915-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 BEAR HILL ROAD",
            "address_2": "SUITE 202",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "02451",
            "telephone_number": "781-966-0070",
            "fax_number": "781-915-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSAVOUSSIS",
        "first_name": "ELEFTHERIA",
        "credential": "PMHCNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "175264",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "175264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.