Kourtney Mantyla-Murphy, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN2357348 Issued in MA

Practice address

4 Brotherton Way
Auburn, MA 01501-2684

Phone

(508) 721-1199

Fax

(508) 453-8019

NPI assigned

Jun 28, 2023

Last updated

Nov 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Reliant Medical Group, Inc

  • Family Medicine Physician
  • Worcester, MA
  • NPI 1720017528
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1942987334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BROTHERTON WAY",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015012684",
            "telephone_number": "508-721-1199",
            "fax_number": "508-453-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 BROTHERTON WAY",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015012684",
            "telephone_number": "508-721-1199",
            "fax_number": "508-453-8019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTYLA-MURPHY",
        "first_name": "KOURTNEY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-28",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2357348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110209614A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maestro Hospice Care, LLC
• Isaiah Rasheed Malone, DMD
• Tricia Lynn Malone, P.T
• Kelly M. Manchester, ARNP
• Angela Ciamarra Mancini, M.D.
• Solomon Frimpong-Manso Manu
• Christine M Manyak, PT
• Cheryl L Mariano-Perugini, NP
• Laurie J Marin, D.O.
• Marcia Boria Mariner, MA

• Family Nurse Practitioner in Auburn, MA
• Providers in Auburn, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.