Individual provider Active NPI

Chalice Santorelli, NP

  • Adult Health Nurse Practitioner
  • Southampton, MA
National Provider Identifier
1972773117
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
267935 Issued in MA
Practice address
6 Parc PL
Southampton, MA 01073-9277
Phone
(413) 582-4740
NPI assigned
Mar 4, 2008
Last updated
Jan 2, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 267935 MA Primary
Women's Health Nurse Practitioner 363LW0102X 267935 MA

Addresses

Primary practice location

6 Parc PL
Southampton, MA 01073-9277

Mailing address

30 Locust St
PO Box 911
Northampton, MA 01060-2052
Phone (413) 582-4740

Other identifiers 1

IdentifierTypeStateIssuer
0720968MedicaidMA

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
I20080415000076 MA Practitioner - Nurse Practitioner 0941387039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10 Denniston PL
Womens Health
Northampton, MA 01060-2052
Phone (413) 586-9866

22 Atwood Dr
Northampton, MA 01060-4267

30 Locust St
Northampton, MA 01060-2052
Phone (413) 582-2441

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
267935MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Western Massachusetts Inc CurrentSince Aug 6, 2012 Accepting new patients
Southampton Pediatrics, LLC Past Accepting new patients
Mass General Brigham Medical Group Western Massachusetts Inc Past Accepting new patients

Locations

30 Locust St
Northampton, MA 01060
Phone (413) 582-2000

Interoperability endpoints

  • Direct secure messaging: santorelli.chalice.cdh@direct.partners.masshiway.net

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1972773117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 LOCUST ST",
            "address_2": "PO BOX 911",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010602052",
            "telephone_number": "413-582-4740",
            "fax_number": "413-582-2958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PARC PL",
            "city": "SOUTHAMPTON",
            "state": "MA",
            "postal_code": "010739277",
            "telephone_number": "413-582-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTORELLI",
        "first_name": "CHALICE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-04",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "267935",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "267935",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0720968",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, MA

Sources for this page

Verify at the official NPI Registry.