Active NPI
Charae J. D'Ambra, N.P.
- Pediatric Nurse Practitioner
- Andover, MA
National Provider Identifier
1912199217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 231679
- Practice address
- 323 Lowell St
Andover, MA 01810-4501 - Phone
- (978) 783-5000
- Fax
- (978) 313-8180
- NPI assigned
- Aug 10, 2007
- Last updated
- Oct 23, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 062444-23 | NH | |
| Pediatric Nurse Practitioner | 363LP0200X | 231679 | MA | Primary |
Addresses
Primary practice location
323 Lowell St
Andover, MA 01810-4501
Mailing address
323 Lowell St
Andover, MA 01810-4501
Phone (978) 783-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30348060 | Medicaid | NH |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 231679 | MA | MD | Pediatric Nurse Practitioner |
| 062444-23 | NH | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pentucket Medical Associates, LLC | Current | Accepting new patients | |
| Bridgewater Pediatrics LLC | Past | Accepting new patients | |
| Mass General Brigham Community Physicians Inc. | Past | Accepting new patients | |
| Good Samaritan Medical Practice Corp | Past | Accepting new patients |
Locations
500 Merrimack St
Lawrence, MA 01843
Phone (978) 557-8800
Interoperability endpoints
- dambra.charae.pma@direct.partners.masshiway.net
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Haverhill, MA
- NPI 1891112637
-
- Emergency Medicine Physician
- Salem, MA
- NPI 1588606123
-
- Internal Medicine Physician
- Haverhill, MA
- NPI 1609872886
-
- Pediatrics Physician
- Bridgewater, MA
- NPI 1255579975
-
- Specialist
- Brockton, MA
- NPI 1285625137
-
dba One Medical
- Family Medicine Physician
- Boston, MA
- NPI 1265094122
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540252800000",
"number": "1912199217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "323 LOWELL ST",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018104501",
"telephone_number": "978-783-5000",
"fax_number": "978-313-8180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "323 LOWELL ST",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018104501",
"telephone_number": "978-783-5000",
"fax_number": "978-313-8180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "D'AMBRA",
"first_name": "CHARAE",
"middle_name": "J.",
"name_prefix": "Mrs.",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-10",
"last_updated": "2018-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NH",
"license": "062444-23",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MA",
"license": "231679",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30348060",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.