Individual provider Active NPI

Arielle Berish

  • Pediatric Nurse Practitioner
  • Brockton, MA
National Provider Identifier
1912406273
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN2313897 Issued in MA
Practice address
179 Quincy St
Brockton, MA 02302-2966
Phone
(508) 427-7700
NPI assigned
Feb 1, 2018
Last updated
Sep 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN2313897 MA Primary
Pediatric Registered Nurse 163WP0200X RN2313897 MA

Addresses

Primary practice location

179 Quincy St
Brockton, MA 02302-2966

Mailing address

10 Seaport Dr
Quincy, MA 02171-1582
Phone (781) 413-1033

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
I20201008002419 MA Practitioner - Nurse Practitioner 5799105904 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2313897MAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Pediatric Associates Inc CurrentSince Aug 1, 2020 Accepting new patients
Pediatric Associates Inc. of Brockton PastSince Nov 1, 2019 Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

800 Washington St
#1013
Boston, MA 02111
Phone (617) 636-0491

179 Quincy St
Brockton, MA 02302
Phone (508) 427-7700

Interoperability endpoints

  • Direct secure messaging: aberish22058@direct.chppoc.masshiway.net

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, 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": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1912406273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SEAPORT DR",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021711582",
            "telephone_number": "781-413-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 QUINCY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022966",
            "telephone_number": "508-427-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERISH",
        "first_name": "ARIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-01",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2313897",
            "primary": true
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MA",
            "license": "RN2313897",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.