Individual provider Active NPI

Rebecca Donadio

  • Psychiatric/Mental Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1871950733
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2286740 Issued in MA
Practice address
84 State Stareet, Suite 660
Boston, MA 02109-2200
Phone
(800) 370-3651
Fax
(877) 515-7147
NPI assigned
Jan 24, 2016
Last updated
Oct 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2286740 MA Primary

Addresses

Primary practice location

84 State Stareet, Suite 660
Boston, MA 02109-2200

Mailing address

55 Hatchetts Hill Rd
Old Lyme, CT 06371-1534
Phone (800) 370-3651

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
I20161121000033 MA Practitioner - Nurse Practitioner 4385923010 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2286740MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Soul Wellness PLLC Psychiatric/Mental Health CurrentSince Oct 19, 2020 Accepting new patients
Vantage Healthcare LLC CurrentSince Dec 1, 2020 Accepting new patients
Mind Soul Wellness of Florida Psychiatric/Mental Health CurrentSince Jan 17, 2022 Accepting new patients

Locations

100 Sylvan Rd
Ste 670
Woburn, MA 01801

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1453593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1871950733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 HATCHETTS HILL RD",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063711534",
            "telephone_number": "800-370-3651",
            "fax_number": "877-515-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 STATE STAREET, SUITE 660",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021092200",
            "telephone_number": "800-370-3651",
            "fax_number": "877-515-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONADIO",
        "first_name": "REBECCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-24",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2286740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.