Maurine Aza Kisob

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

RN2290966 Issued in MA

Practice address

100 Concord St Ste 2a&B
Framingham, MA 01702-8328

Phone

(508) 817-5041

NPI assigned

Mar 3, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bloom Mental Wellness Center, LLC

  • Psychiatric/Mental Health Registered Nurse
  • Milford, MA
  • NPI 1053270967
  Medicare reassignment NPD Authorized official
• Partners Counseling and Family Services, Inc.

  • Clinic/Center
  • Framingham, MA
  • NPI 1619555331
  Medicare reassignment NPD

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1841990462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CONCORD ST STE 2A&B",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017028328",
            "telephone_number": "508-817-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CONCORD ST STE 2A&B",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017028328",
            "telephone_number": "508-817-5041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISOB",
        "first_name": "MAURINE",
        "middle_name": "AZA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-03",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2290966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Kinney
• Jacqueline Marie Kinsley
• George P Kinzfogl III, MD
• Lindsey Kirchoff, AGACNP-BC
• Michelle Marie Kish, DPT, MS
• Jennifer Louie Kittenplan
• Henry Klapholz, M.D.
• David A. Klegon, M.D.
• Justin Benjamin Klein-Edgerton
• Audrey Lynne Kleinberg, MA

• Psychiatric/Mental Health Registered Nurse in Framingham, MA
• Providers in Framingham, MA by specialty
• Psychiatric/Mental Health Registered Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.