Individual provider Active NPI

Anne Koneru

  • Psychiatric/Mental Health Nurse Practitioner
  • Springfield, MA
National Provider Identifier
1992940365
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2259886 Issued in MA
Practice address
417 Liberty St Ste 2
Springfield, MA 01104-3766
Phone
(413) 301-9355
NPI assigned
Dec 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3957 CT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2259886 MA Primary
Family Nurse Practitioner 363LF0000X RN2259886 MA
Family Nurse Practitioner 363LF0000X 003957 CT

Addresses

Primary practice location

417 Liberty St Ste 2
Springfield, MA 01104-3766

Mailing address

701 Cottage Grove Rd Ste B110
Bloomfield, CT 06002-4217
Phone (203) 637-5882

Other practice location 1

701 Cottage Grove Rd Ste B110
Bloomfield, CT 06002-4217
Phone (203) 637-5882

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
I20091030000142 MA Practitioner - Nurse Practitioner 8022172667 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
Behavioral Health Network IncGroup PAC ID 3072596360, 146 clinicians

Practice addresses (Care Compare)

417 Liberty St
Springfield, MA 01104-3736
Phone (413) 736-3668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003957CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Network Inc CurrentSince Dec 21, 2023 Accepting new patients
Behavioral Health Network, Inc CurrentSince Dec 21, 2023 Accepting new patients

Locations

230 Maple St
Ste 350
Holyoke, MA 01040
Phone (413) 272-0715

40 Bobala Rd
Holyoke, MA 01040
Phone (413) 536-5473

417 Liberty St
Springfield, MA 01104
Phone (413) 733-6661

417 Liberty St
Ste 2
Springfield, MA 01104
Phone (413) 301-9406

Interoperability endpoints

  • Direct secure messaging: anne.koneru@xdr.hhchealthdirect.org

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": "1229040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1992940365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 COTTAGE GROVE RD STE B110",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060024217",
            "telephone_number": "203-637-5882",
            "fax_number": "855-524-3980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 LIBERTY ST STE 2",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011043766",
            "telephone_number": "413-301-9355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Cottage Grove Rd Ste B110",
            "address_purpose": "LOCATION",
            "city": "Bloomfield",
            "state": "CT",
            "postal_code": "060024217",
            "country_code": "US",
            "telephone_number": "203-637-5882",
            "fax_number": "855-524-3980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONERU",
        "first_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-12",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "3957",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2259886",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2259886",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "003957",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.