| Brent Medeiros, | |
| 1030 President Ave Rm 304, Fall River, MA 02720-5923 | |
| (508) 235-6427 | |
| (508) 235-6654 | 
| Full Name | Brent Medeiros | 
|---|---|
| Gender | Male | 
| Speciality | Nurse Practitioner | 
| Location | 1030 President Ave Rm 304, Fall River, Massachusetts | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1598362311 | NPI | - | NPPES | 
| APRN02417 | Other | RI | APRN LICENSE | 
| RN2293550 | Other | MA | APRN LICENSE | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363L00000X | Nurse Practitioner | APRN02417 (Rhode Island) | Secondary | 
| 363L00000X | Nurse Practitioner | RN2293550 (Massachusetts) | Primary | 
| Entity Name | Southcoast Physicians Group Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1336137629 PECOS PAC ID: 0749171957 Enrollment ID: O20040920000138 | 
| Entity Name | Fall River Nephrology Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1407064348 PECOS PAC ID: 1850465022 Enrollment ID: O20080806000291 | 
| Entity Name | Sturdy Health Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1063866176 PECOS PAC ID: 9537152806 Enrollment ID: O20160811001583 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Brent Medeiros, 226 Beckwith St, Cranston, RI 02910-1851 Ph: () - | Brent Medeiros, 1030 President Ave Rm 304, Fall River, MA 02720-5923 Ph: (508) 235-6427 | 
| Erin E Dacey, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 363 Highland Ave, Fall River, MA 02720 Phone: 508-973-5918 Fax: 508-973-5916 | |
| Katherine E Serra, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 386 Stanley St, Fall River, MA 02720 Phone: 508-679-5222 Fax: 508-673-3182 | |
| Matthew Paul Bock, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 386 Stanley St, Fall River, MA 02720 Phone: 508-679-5222 Fax: 508-673-3182 | |
| Alicia Larock, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 363 Highland Ave, Fall River, MA 02720 Phone: 508-679-3131 | |
| Jessica Lynn Shippee,  Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 363 Highland Ave, Fall River, MA 02720 Phone: 508-973-7109 Fax: 508-973-7149 | |
| Maxine Dube, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 400 Stanley St, Fall River, MA 02720 Phone: 508-675-1054 Fax: 508-324-7777 | |
| Matthew Braga, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 795 Middle St, Fall River, MA 02721 Phone: 508-674-5600 |