Individual provider Active NPI

Lesly Wood

  • Gerontology Nurse Practitioner
  • Fall River, MA
National Provider Identifier
1922678564
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN26303986 Issued in MA
Practice address
1030 President Ave
Fall River, MA 02720-5923
Phone
(508) 973-1690
Fax
(508) 973-1715
NPI assigned
Jun 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2303986 MA
Gerontology Nurse Practitioner 363LG0600X RN26303986 MA Primary

Addresses

Primary practice location

1030 President Ave
Fall River, MA 02720-5923

Mailing address

5 Brady St
Warren, RI 02885-2022
Phone (508) 264-5986

Other identifiers 1

IdentifierTypeStateIssuer
110174364AMedicaidMA

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
I20210923003055 MA Practitioner - Nurse Practitioner 5890192462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

1030 President Ave
RM 110
Fall River, MA 02720-5923
Phone (508) 676-3411

Hospital & facility affiliations

  • Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2303986MAMDNurse Practitioner
RN26303986MAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Sep 1, 2021 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Sep 1, 2021 Accepting new patients

Locations

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

1030 President Ave
Rm 110
Fall River, MA 02720
Phone (508) 235-6349

1030 President Ave
Fall River, MA 02720
Phone (508) 235-6427

300A Faunce Corner Rd
Ste 200
North Dartmouth, MA 02747
Phone (508) 973-2213

Interoperability endpoints

  • Direct secure messaging: lwood35421@direct.southcoast.org

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": "1624752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1922678564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BRADY ST",
            "city": "WARREN",
            "state": "RI",
            "postal_code": "028852022",
            "telephone_number": "508-264-5986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 PRESIDENT AVE",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027205923",
            "telephone_number": "508-973-1690",
            "fax_number": "508-973-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "LESLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-27",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "2303986",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN26303986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110174364A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.