MRS. MYRA F CACACE GNP/ADM-BC CDE NPI 1518956010

NPI Information

NPI: 1518956010
Provider Name: MRS. MYRA F CACACE, GNP/ADM-BC, CDE
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

PECOS Registration: Yes

Address:
5 NEPONSET ST
WORCESTER, MA
ZIP 01606
Phone: (508) 852-6175
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MRS. Myra F Cacace, GNP/ADM-BC, CDE is a primary care nurse practitioner in Worcester, MA. MRS. Myra F Cacace, GNP/ADM-BC, CDE NPI is 1518956010. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5 NEPONSET ST
WORCESTER, MA
ZIP 01606-714
Phone: (508) 852-6175
Fax: (508) 595-2123

The NPI 1518956010 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/18/2005 and was last updated on 9/27/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WC0200X	Registered Nurse	Critical Care Medicine	NP144577	MASSACHUSETTS	No
2	363LG0600X	Nurse Practitioner	Gerontology	NP144577	MASSACHUSETTS	No
3	363LP2300X	Nurse Practitioner	Primary Care	NP144577	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	BCNP0559	OTHER	MASSACHUSETTS	BLUE CROSS BLUE SHIELD
2	110015470A	MEDICAID	MASSACHUSETTS
3	49852	OTHER	MASSACHUSETTS	FALLON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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