Individual provider Active NPI

Marian E Idahosa

  • Family Nurse Practitioner
  • Woonsocket, RI
National Provider Identifier
1962973164
Registry record updated Feb 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN01982 Issued in RI
Practice address
1054 Cass Ave
Woonsocket, RI 02895-4935
Phone
(866) 389-2727
NPI assigned
Dec 16, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN49908 RI
Family Nurse Practitioner 363LF0000X APRN01982 RI Primary

Addresses

Primary practice location

1054 Cass Ave
Woonsocket, RI 02895-4935

Mailing address

1054 Cass Avenue
Woonsocket, RI 02895-5947

Other practice location 1

1054 Cass Ave
Woonsocket, RI 02895-4935
Phone (186) 638-9272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20190215001887 RI Practitioner - Nurse Practitioner 2769720788 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Supportive Care I of Rhode Island PCGroup PAC ID 1951793546, 53 clinicians

Practice addresses (Care Compare)

17 Adelphi Ave
Providence, RI 02906-4119
Phone (718) 298-4375

867 Park Ave
Woonsocket, RI 02895-5872
Phone (401) 633-2577

Merit-based Incentive Payment System (MIPS)

Final score
69.09 of 100Reported as group
Quality
73.07
Promoting interoperability
0
Improvement activities
40
Cost
73.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN01982RIMDFamily Nurse Practitioner
RN49908RIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Map Behavioral Health Services Inc. CurrentSince Jul 26, 2023 Accepting new patients
Hosa Health and Wellness Center LLC Psychiatric/Mental Health CurrentSince Aug 13, 2023 Accepting new patients
Supportive Care I of Rhode Island PC CurrentSince Jul 3, 2023 Accepting new patients
Hosa Health and Wellness Center LLC Family CurrentSince Jun 15, 2023 Accepting new patients
Map Behavioral Health Group PastSince Apr 24, 2022 Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

66 Burnett St
Providence, RI 02907
Phone (401) 785-0050

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.

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739664000000",
    "number": "1962973164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1054 CASS AVENUE",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028955947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1054 CASS AVE",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028954935",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1054 Cass Ave",
            "address_purpose": "LOCATION",
            "city": "Woonsocket",
            "state": "RI",
            "postal_code": "028954935",
            "country_code": "US",
            "telephone_number": "186-638-9272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IDAHOSA",
        "first_name": "MARIAN",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2025-02-16",
        "certification_date": "2025-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "RI",
            "license": "RN49908",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN01982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

Verify at the official NPI Registry.