| Meditelecare Of Massachusetts, Pllc | |
|
84 State St Boston MA 02109-2202 | |
| (860) 788-6404 | |
| (860) 829-0495 |
| Full Name | Meditelecare Of Massachusetts, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 84 State St, Boston, Massachusetts |
| Authorized Official Name and Position | Andrea Godfrey (CREDENTIALING & ENROLLMENT MANAGER) |
| Authorized Official Contact | 8603986441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meditelecare Of Massachusetts, Pllc Po Box 1595 Middletown CT 06457-8095 Ph: (860) 788-6404 | Meditelecare Of Massachusetts, Pllc 84 State St Boston MA 02109-2202 Ph: (860) 788-6404 |
| NPI Number | 1003496506 |
|---|---|
| Provider Enumeration Date | 04/09/2021 |
| Last Update Date | 05/05/2025 |
| Certification Date | 05/05/2025 |
| Medicare PECOS PAC ID | 8921417064 |
|---|---|
| Medicare Enrollment ID | O20210503000425 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003496506 | NPI | - | NPPES |
| Provider Name | Stephanie C Rondeau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184813214 PECOS PAC ID: 0446348726 Enrollment ID: I20071120000535 |
| Provider Name | Virginia Ann Rockhill |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528097383 PECOS PAC ID: 8426071002 Enrollment ID: I20121019000154 |
| Provider Name | Marielle Pitts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518215490 PECOS PAC ID: 0840441879 Enrollment ID: I20121121000234 |
| Provider Name | Corey Baechel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003149972 PECOS PAC ID: 6800119843 Enrollment ID: I20141229000161 |
| Provider Name | Marie Natacha Francis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689043465 PECOS PAC ID: 9335438001 Enrollment ID: I20160519000695 |
| Provider Name | Joanna B Machain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932561289 PECOS PAC ID: 0648562074 Enrollment ID: I20160706000399 |
| Provider Name | Kara N Lindemayer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376099416 PECOS PAC ID: 2668750852 Enrollment ID: I20161021001684 |
| Provider Name | Eileen Elizabeth Batchelor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952714172 PECOS PAC ID: 4587948781 Enrollment ID: I20170308000447 |
| Provider Name | Sarah Bione-dunn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356579395 PECOS PAC ID: 9032438171 Enrollment ID: I20170614001074 |
| Provider Name | Megan L Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356888390 PECOS PAC ID: 8729354311 Enrollment ID: I20171026001376 |
| Provider Name | Stephany Gyasi |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1508369166 PECOS PAC ID: 1355603663 Enrollment ID: I20180327001198 |
| Provider Name | Erica Marie Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487125217 PECOS PAC ID: 8820334345 Enrollment ID: I20190103002845 |
| Provider Name | Kelly Lincoln |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518591619 PECOS PAC ID: 2163847625 Enrollment ID: I20200731001058 |
| Provider Name | Elizabeth Martell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730676370 PECOS PAC ID: 3971923061 Enrollment ID: I20201012000037 |
| Provider Name | Tatum Siebert |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528389566 PECOS PAC ID: 8527462886 Enrollment ID: I20210814000121 |
| Provider Name | Arlie Sterling |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508260860 PECOS PAC ID: 1355730672 Enrollment ID: I20220513000574 |
| Provider Name | Steven Afrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871946152 PECOS PAC ID: 9739454307 Enrollment ID: I20220614000957 |
| Provider Name | John Dixon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023256930 PECOS PAC ID: 7416986781 Enrollment ID: I20221201000942 |
| Provider Name | Erica Beachy-randall |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982953352 PECOS PAC ID: 9032582903 Enrollment ID: I20230224001307 |
| Provider Name | Tarah Foley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962128686 PECOS PAC ID: 6800268293 Enrollment ID: I20230505000915 |
| Provider Name | Jillian Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215317268 PECOS PAC ID: 5193189041 Enrollment ID: I20230922003388 |
| Provider Name | Amina Fout |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962035840 PECOS PAC ID: 2264979954 Enrollment ID: I20240730003563 |
| Provider Name | Susan Estrela |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013566397 PECOS PAC ID: 5092240127 Enrollment ID: I20241206000320 |
| Provider Name | Katelyn Henault |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669960084 PECOS PAC ID: 7810425519 Enrollment ID: I20250108003729 |
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