Individual provider Active NPI

Eliane K Fogue

  • Psychiatric/Mental Health Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1942600275
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN9518901 Issued in MA
Practice address
26 Queen St Ste 13
Worcester, MA 01610-2478
Phone
(508) 860-7700
NPI assigned
Aug 22, 2014
Last updated
Sep 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN9518901 MA Primary
Mental Health Counselor 101YM0800X NU
Registered Nurse 163W00000X RN9518901 MA

Addresses

Primary practice location

26 Queen St Ste 13
Worcester, MA 01610-2478

Mailing address

26 Queen St Ste 13
Worcester, MA 01610-2478
Phone (508) 860-7700

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
I20250929003641 MA Practitioner - Nurse Practitioner 5698271773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

26 Queen St
Worcester, MA 01610-2473
Phone (508) 860-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Center of Worcester, Inc. CurrentSince Oct 27, 2025 Accepting new patients
Family Health Center of Worcester, Inc. CurrentSince Oct 27, 2025 Accepting new patients

Locations

26 Queen St
Worcester, MA 01610
Phone (508) 860-7700

26 Queen St
Ste 13
Worcester, MA 01610
Phone (508) 860-7700

Interoperability endpoints

  • Direct secure messaging: efogue52479@direct.ctc.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": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1942600275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 QUEEN ST STE 13",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102478",
            "telephone_number": "508-860-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 QUEEN ST STE 13",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102478",
            "telephone_number": "508-860-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGUE",
        "first_name": "ELIANE",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-22",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN9518901",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN9518901",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.