Individual provider Active NPI

Alfred Owusu-Ansah, DNP

  • Gerontology Nurse Practitioner
  • Charlton, MA
National Provider Identifier
1881349140
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AG02220081 Issued in MA
Practice address
19 Deer Run
Charlton, MA 01507-1577
Phone
(508) 612-4881
NPI assigned
Feb 15, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AG02220081 MA Primary

Addresses

Primary practice location

19 Deer Run
Charlton, MA 01507-1577

Mailing address

19 Deer Run
Charlton, MA 01507-1577
Phone (508) 612-4881

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
I20240228002880 MA Practitioner - Nurse Practitioner 9830534924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lianne IncGroup PAC ID 4587889365, 14 clinicians

Practice addresses (Care Compare)

95 Lincoln St
Worcester, MA 01605-2441
Phone (508) 453-3223

Hospital & facility affiliations

  • Adcare Hospital of Worcester Inc Hospital, Worcester, MA, CCN 220062

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AG02220081MAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lianne Inc CurrentSince Dec 10, 2023 Accepting new patients

Locations

95 Lincoln St
Worcester, MA 01605
Phone (508) 453-3053

Organizations & group practices 1

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": "1644883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1881349140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 DEER RUN",
            "city": "CHARLTON",
            "state": "MA",
            "postal_code": "015071577",
            "telephone_number": "508-612-4881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 DEER RUN",
            "city": "CHARLTON",
            "state": "MA",
            "postal_code": "015071577",
            "telephone_number": "508-612-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWUSU-ANSAH",
        "first_name": "ALFRED",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-15",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "AG02220081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlton, MA

Sources for this page

Verify at the official NPI Registry.