Individual provider Active NPI

Nancy Ellen Braese, DO

  • Family Medicine Physician
  • Dover, NH
National Provider Identifier
1932176328
Registry record updated Jan 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7457 Issued in NH
Practice address
10 Members Way
Suite 200
Dover, NH 03820-5933
Phone
(603) 609-6930
NPI assigned
Mar 3, 2006
Last updated
Jan 2, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7457 NH Primary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 7457 NH

Addresses

Primary practice location

10 Members Way
Suite 200
Dover, NH 03820-5933

Mailing address

789 Central Ave
Dover, NH 03820-2526
Phone (603) 740-4478

Other identifiers 1

IdentifierTypeStateIssuer
3076887MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080123000456 NH Practitioner - Family Practice 5890877310 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

311 Route 108
Somersworth, NH 03878-1522
Phone (603) 749-2346

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7457NHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Seacoast Community Health CurrentSince Aug 1, 2020 Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Jan 1, 2017 Accepting new patients
Wentworth Douglass Physician Corporation Family Medicine CurrentSince Jan 1, 2017 Accepting new patients
Greater Seacoast Community Health CurrentSince Aug 1, 2020 Accepting new patients

Locations

10 Members Way
Ste 200
Dover, NH 03820
Phone (603) 609-6930

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

311 Route 108
Somersworth, NH 03878
Phone (603) 422-8208

Interoperability endpoints

  • Direct secure messaging: nancy.braese.1@28518.direct.athenahealth.com

Organizations & group practices 4

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483315200000",
    "number": "1932176328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-740-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MEMBERS WAY",
            "address_2": "SUITE 200",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038205933",
            "telephone_number": "603-609-6930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAESE",
        "first_name": "NANCY",
        "middle_name": "ELLEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-03",
        "last_updated": "2017-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "7457",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NH",
            "license": "7457",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3076887",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.