Individual provider Active NPI

Mavis Amankwah, BSN, MSN, FNP

  • Family Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1962944561
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2289795 Issued in MA
Practice address
123 Summer St
Worcester, MA 01608-1216
Phone
(508) 363-6849
Fax
(508) 363-7461
NPI assigned
Nov 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2289795 MA Primary

Addresses

Primary practice location

123 Summer St
Worcester, MA 01608-1216

Mailing address

123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-6849

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
I20170404001735 MA Practitioner - Nurse Practitioner 9234415373 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Physicians of Massachusetts PCGroup PAC ID 4183038359, 84 clinicians

Practice addresses (Care Compare)

123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-9394

Hospital & facility affiliations

  • St Vincent Hospital Hospital, Worcester, MA, CCN 220176
  • Umass Memorial Healthalliance Hospitals Hospital, Leominster, MA, CCN 220001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Massachusetts Inc Current Accepting new patients
Saint Vincent Physician Services, Inc. CurrentSince Mar 20, 2017 Accepting new patients
Sound Physicians of Massachusetts Inc CurrentSince Aug 1, 2018 Accepting new patients
Hospitalist Physicians of Massachusetts PC CurrentSince Feb 1, 2021 Accepting new patients
Sound Physicians of Massachusetts, Inc CurrentSince Aug 1, 2018 Accepting new patients

Locations

115 Lincoln St
Framingham, MA 01702
Phone (508) 383-1000

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

123 Summer St
#273
Worcester, MA 01608
Phone (508) 363-6327

1445 Ross Ave
Ste 1400
Dallas, TX 75202
Phone (469) 893-6465

Organizations & group practices 5

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 3

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": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1962944561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-363-6849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-363-6849",
            "fax_number": "508-363-7461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMANKWAH",
        "first_name": "MAVIS",
        "credential": "BSN, MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-14",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2289795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.