Individual provider Active NPI

Kathleen Dolores Absalom, N.P.

  • Nurse Practitioner
  • Haverhill, MA
National Provider Identifier
1841303963
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN274443 Issued in MA
Practice address
600 Primrose St Ste 202
Haverhill, MA 01830-2659
Phone
(978) 556-0100
Fax
(785) 560-1019
NPI assigned
Aug 15, 2006
Last updated
Apr 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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 RN274443 MA Primary
Licensed Practical Nurse 164W00000X 274443 MA

Addresses

Primary practice location

600 Primrose St Ste 202
Haverhill, MA 01830-2659

Mailing address

600 Primrose St Ste 202
Haverhill, MA 01830-2659
Phone (978) 556-0100

Other practice location 1

255 Low St Ste 101
Newburyport, MA 01950-3596
Phone (978) 255-4607

Other identifiers 1

IdentifierTypeStateIssuer
1000039976MedicaidDE

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
I20210621003197 MA Practitioner - Nurse Practitioner 3971526112 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seacoast Affiliated Group Practice IncGroup PAC ID 1658357843, 50 clinicians

Practice addresses (Care Compare)

600 Primrose St
Suite 202
Haverhill, MA 01830-2659
Phone (978) 556-0100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
274443MAMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seacoast Affiliated Group Practice, Inc. CurrentSince Jul 25, 2023 Accepting new patients
Delmarva Rural Ministries, Inc. Past Accepting new patients
River Valley Infectious Disease Specialists Inc. Past Accepting new patients
Newburyport Cardiovascular Associates, LLC PastSince Jul 25, 2023 Accepting new patients
Anna Jaques Hospital PastSince Jul 25, 2023 Accepting new patients

Locations

600 Primrose St
Haverhill, MA 01830
Phone (888) 227-3762

600 Primrose St
Ste 202
Haverhill, MA 01830
Phone (978) 556-0100

21 Highland Ave
Ste 5
Newburyport, MA 01950
Phone (978) 255-4217

255 Low St
Ste 101
Newburyport, MA 01950
Phone (978) 255-4607

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDCHAA/Endpoint/EDCHAA
  • Direct secure messaging: kabsalom456518@direct.bilh.masshiway.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1841303963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 PRIMROSE ST STE 202",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018302659",
            "telephone_number": "978-556-0100",
            "fax_number": "978-681-4507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PRIMROSE ST STE 202",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018302659",
            "telephone_number": "978-556-0100",
            "fax_number": "785-560-1019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 Low St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Newburyport",
            "state": "MA",
            "postal_code": "019503596",
            "country_code": "US",
            "telephone_number": "978-255-4607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABSALOM",
        "first_name": "KATHLEEN",
        "middle_name": "DOLORES",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN274443",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MA",
            "license": "274443",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000039976",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverhill, MA

Sources for this page

Verify at the official NPI Registry.