Individual provider Active NPI

Cynthia C Iwunze, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Quincy, MA
National Provider Identifier
1821776774
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2304852 Issued in MA
Practice address
100 Hancock St FL 9
Quincy, MA 02171-1745
Phone
(508) 927-1176
NPI assigned
Jul 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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 RN2304852 MA Primary

Addresses

Primary practice location

100 Hancock St FL 9
Quincy, MA 02171-1745

Mailing address

8 Thomas Salamone Cir
Randolph, MA 02368-3955
Phone (617) 895-9553

Other practice location 1

8 Thomas Salamone Cir
Randolph, MA 02368-3955
Phone (617) 895-9553

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
I20230801002567 MA Practitioner - Nurse Practitioner 9133590391 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

30 Taunton GRN
Suite 5
Taunton, MA 02780-3243
Phone (508) 880-6666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2304852MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Health Services, LLC CurrentSince Aug 1, 2023 Accepting new patients
Supportive Behavioral Care of Ma LLC CurrentSince Jan 15, 2025 Accepting new patients
Northeast Health Services PastSince Aug 1, 2023 Accepting new patients

Locations

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

100 Hancock St
Fl 9
Quincy, MA 02171
Phone (508) 927-1176

30 Taunton Grn
Ste 5
Taunton, MA 02780
Phone (508) 545-7400

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

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pearl Homecare IncTewksbury, MA, CCN 227779 Home health agency 5% Or Greater Direct Ownership Interest (33%)
Corporate Officer (33%)
W-2 Managing Employee (33%)
Oct 22, 2022
Oct 22, 2022
Oct 22, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1821776774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 THOMAS SALAMONE CIR",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023683955",
            "telephone_number": "617-895-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HANCOCK ST FL 9",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021711745",
            "telephone_number": "508-927-1176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 Thomas Salamone Cir",
            "address_purpose": "LOCATION",
            "city": "Randolph",
            "state": "MA",
            "postal_code": "023683955",
            "country_code": "US",
            "telephone_number": "617-895-9553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IWUNZE",
        "first_name": "CYNTHIA",
        "middle_name": "C",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2304852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.