NPIMap

Organization Active NPI

Vista Health Care Solution

  • Psychiatric/Mental Health Nurse Practitioner
  • Salem, MA
National Provider Identifier
1831898253
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
VISTA HEALTH CARE SOLUTION
Practice address
84 Highland Ave Ste 304
Salem, MA 01970-2733
Phone
(781) 521-0302
NPI assigned
Feb 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Authorized official

Name
Dr. Abila Primus Benazea, DNPNPI 1619305521
Title
Ceo
Phone
(781) 521-0302

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Recovery Care Clinic/Center 261QR0800X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

84 Highland Ave Ste 304
Salem, MA 01970-2733

Mailing address

9 Vista Ave
Salem, MA 01970-1027
Phone (781) 521-0302

Other identifiers 1

IdentifierTypeStateIssuer
279930OtherMALICENSE NUMBER

Other names 1

  • VISTA MAT LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231113002556 MA Part B Supplier - Clinic/Group Practice 3072960046 Receives reassigned benefits from 1 practitioner
Practice locations: Salem, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1677196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697587200000",
    "number": "1831898253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 VISTA AVE",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019701027",
            "telephone_number": "781-521-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 HIGHLAND AVE STE 304",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702733",
            "telephone_number": "781-521-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA HEALTH CARE SOLUTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-24",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A",
        "authorized_official_last_name": "BENAZEA",
        "authorized_official_first_name": "ABILA",
        "authorized_official_middle_name": "PRIMUS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "781-521-0302",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "279930",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VISTA MAT LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VISTA MAT LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.