Individual provider Active NPI

Danielle N Moncrieffe, MD

  • Pediatrics Physician
  • Shrewsbury, MA
National Provider Identifier
1952625766
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
269649 Issued in MA
Practice address
378 Maple Ave
Shrewsbury, MA 01545-2675
Phone
(508) 852-8571
Fax
(508) 535-1662
NPI assigned
Mar 23, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 269649 MA Primary

Addresses

Primary practice location

378 Maple Ave
Shrewsbury, MA 01545-2675

Mailing address

5 Neponset St
Worcester, MA 01606-2714
Phone (508) 852-8571

Other identifiers 1

IdentifierTypeStateIssuer
110122482AMedicaidMA

Other names 1

  • Danielle Laverne Nixon Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170830000135 MA Practitioner - Pediatric Medicine 5193098986 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
269649MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Pediatrics CurrentSince Jul 18, 2017 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

225 New Lancaster Rd
Leominster, MA 01453
Phone (978) 466-3208

378 Maple Ave
Shrewsbury, MA 01545
Phone (508) 595-2513

630 Plantation St
Fl 12
Worcester, MA 01605
Phone (508) 368-5529

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

5 Neponset St
#2
Worcester, MA 01606

Interoperability endpoints

  • Direct secure messaging: danielle.moncrieffe.npi1952625766.reliant@direct.optumcare.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1952625766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714",
            "telephone_number": "508-852-8571",
            "fax_number": "508-535-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 MAPLE AVE",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "015452675",
            "telephone_number": "508-852-8571",
            "fax_number": "508-535-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONCRIEFFE",
        "first_name": "DANIELLE",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-23",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "269649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110122482A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "NIXON",
            "middle_name": "LAVERNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shrewsbury, MA

Sources for this page

Verify at the official NPI Registry.