Individual provider Active NPI

Peter Wainaina, NP

  • Nurse Practitioner
  • Canton, MA
National Provider Identifier
1861267445
Registry record updated Nov 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN279463 Issued in MA
Practice address
95 Washington St Ste 104177
Canton, MA 02021-4006
Phone
(781) 366-0310
NPI assigned
Nov 23, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN279463 MA Primary

Addresses

Primary practice location

95 Washington St Ste 104177
Canton, MA 02021-4006

Mailing address

392 Highland St
Stoughton, MA 02072-3878
Phone (781) 424-9962

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
I20240322000572 MA Practitioner - Nurse Practitioner 9335586643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Circle Medical Team LLCGroup PAC ID 2860822905, 9 clinicians

Practice addresses (Care Compare)

305 Walpole St
Norwood, MA 02062-3021
Phone (781) 366-0310

Hospital & facility affiliations

  • Preferred Transitions Home Health Care Inc Home health agency, Milford, MA, CCN 227666

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN279463MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Circle Medical Team LLC CurrentSince Jan 10, 2024 Accepting new patients
Ajay Anand MD PC PastSince Nov 26, 2023 Accepting new patients

Locations

95 Washington St
Ste 224177
Canton, MA 02021

95 Washington St
Ste 104177
Canton, MA 02021
Phone (781) 366-0310

305 Walpole St
Norwood, MA 02062
Phone (781) 366-0310

Organizations & group practices 2

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.

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": "1700697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700697600000",
    "number": "1861267445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "392 HIGHLAND ST",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020723878",
            "telephone_number": "781-424-9962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 WASHINGTON ST STE 104177",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020214006",
            "telephone_number": "781-366-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAINAINA",
        "first_name": "PETER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-23",
        "last_updated": "2023-11-23",
        "certification_date": "2023-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN279463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MA

Sources for this page

Verify at the official NPI Registry.