Divine C Ezewuzie, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN267871 Issued in MA

Practice address

118 Belmont St
Malden, MA 02148-7769

Phone

(781) 656-2256

NPI assigned

Jan 23, 2013

Last updated

Mar 14, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Supportive Behavioral Care of Ma LLCGroup PAC ID 8628346731, 103 clinicians

Charter Health PCGroup PAC ID 1153604079, 26 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.67 of 100Reported as group

Quality

71.18

Improvement activities

40

Cost

75.07

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dezewuzie53309@direct.challiance.masshiway.net

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.

• Charter Health PC

  • Internal Medicine Physician
  • Salem, MA
  • NPI 1750824124
  Medicare reassignment Care Compare group NPD
• Supportive Behavioral Care of Ma LLC

  • Clinical Psychologist
  • Needham, MA
  • NPI 1780115519
  Medicare reassignment Care Compare group NPD
• Trive Tru Health Services Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Wakefield, MA
  • NPI 1457114944
  Medicare reassignment NPD Authorized official
• Cambridge Public Health Commission

  dba Cambridge Health Alliance

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1487603585
  Medicare reassignment NPD
• Charter LTC LLC

  • Internal Medicine Physician
  • Salem, MA
  • NPI 1861129819
  Medicare reassignment NPD
• Cambridge Public Health Commission

  • Psychiatric Hospital Unit
  • Cambridge, MA
  • NPI 1447348313
  NPD
• Cambridge Public Health Commission

  dba Cambridge Health Alliance

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1932313228
  NPD

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1831437011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 BELMONT ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021487769",
            "telephone_number": "781-656-2256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 BELMONT ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021487769",
            "telephone_number": "781-656-2256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEWUZIE",
        "first_name": "DIVINE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-23",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN267871",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN267871",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Malden, MA
• Providers in Malden, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.