Egbe Benedicta Adekunle-Moses I

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LN90968 Issued in MA

Practice address

229 Hebron St
Hyde Park, MA 02136-6201

Phone

(857) 544-9755

NPI assigned

Jan 28, 2016

Last updated

Jan 28, 2016By 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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Northeast Health Services, LLC

  dba Hyland Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Taunton, MA
  • NPI 1225067481
  Medicare reassignment Care Compare group
• Revival Health Care

  • Nursing Care Agency
  • Hyde Park, MA
  • NPI 1447093786
  NPD Authorized official

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1851759302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 HEBRON ST",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021366201",
            "telephone_number": "857-544-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 HEBRON ST",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021366201",
            "telephone_number": "857-544-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEKUNLE-MOSES",
        "first_name": "EGBE",
        "middle_name": "BENEDICTA",
        "name_prefix": "Mrs.",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-28",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MA",
            "license": "LN90968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruthline Abraham, PHARMD
• Academy of the Pacific Rim
• Ace Dental Boston
• Edgar Acosta
• Mervin L Adams
• Edith Agbonghagbonse
• Adefikayo Ajao
• Alegrias LLC
• Vic Ann Visitacion Aloquina, PT
• Neissa Ambroise

• Licensed Practical Nurse in Hyde Park, MA
• Providers in Hyde Park, MA by specialty
• Licensed Practical Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.