Phouangmaly Mimi Oupravanh, DNP in Mansfield, MA

Phouangmaly Mimi Oupravanh, DNP is a medicare enrolled "Nurse Practitioner" in Mansfield, Massachusetts. Her current practice location is 200 Copeland Dr, Mansfield, Massachusetts. You can reach out to her office (for appointments etc.) via phone at (508) 339-4144.

Phouangmaly Mimi Oupravanh is licensed to practice in Massachusetts (license number RN2338222) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1346875531.

Contact Information

	Phouangmaly Mimi Oupravanh, DNP
	200 Copeland Dr, Mansfield, MA 02048-1225
	(508) 339-4144
	(508) 342-1929

Map and Direction

Provider's Profile

Full Name	Phouangmaly Mimi Oupravanh
Gender	Female
Speciality	Nurse Practitioner
Location	200 Copeland Dr, Mansfield, Massachusetts
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1346875531
Provider Enumeration Date: 03/08/2020
Last Update Date: 06/09/2025

Medicare PECOS Information:

PECOS PAC ID: 8527447200
Enrollment ID: I20220627002611

Medical Identifiers

Medical identifiers for Phouangmaly Mimi Oupravanh such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1346875531	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	RN2338222 (Massachusetts)	Secondary
363L00000X	Nurse Practitioner	RN2338222 (Massachusetts)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Phouangmaly Mimi Oupravanh allows following entities to bill medicare on her behalf.

Entity Name	Edward M Kennedy Community Health Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1609842152 PECOS PAC ID: 3476512740 Enrollment ID: O20041004000840

Entity Name	Sturdy Health Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1871515874 PECOS PAC ID: 9537152806 Enrollment ID: O20240830000458

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Phouangmaly Mimi Oupravanh is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Phouangmaly Mimi Oupravanh, DNP 45 Farnum St, Blackstone, MA 01504-2224 Ph: (401) 692-1516	Phouangmaly Mimi Oupravanh, DNP 200 Copeland Dr, Mansfield, MA 02048-1225 Ph: (508) 339-4144

Reviews and Comments

Nurse Practitioner Nurses in Mansfield, MA

Megan Dewey, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 205 Chauncy St, Mansfield, MA 02048 Phone: 508-339-7434 Fax: 508-339-5837
Mrs. Bernadette Marie Jones, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 100 Copeland Dr, Suite 7, Mansfield, MA 02048 Phone: 508-954-2372
Dr. Zachary Rega-oliveira, DNP, APRN-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 158 Copeland Dr, Mansfield, MA 02048 Phone: 401-474-9660 Fax: 866-676-6444
Nancy Ann Walsh, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 200 Copeland Dr, Mansfield, MA 02048 Phone: 508-339-4144 Fax: 508-261-9940
Jennifer Leigh Blood, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 205 Chauncy St, Mansfield, MA 02048 Phone: 508-339-7434 Fax: 508-339-5837
Christina Mitchell, CPNP-PC, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 89 Forbes Blvd Ste 1000a, Mansfield, MA 02048 Phone: 781-326-7700 Fax: 781-251-0910
Mrs. Emily Marie Buckley, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 136 Oak St, Mansfield, MA 02048 Phone: 508-369-6099

Phouangmaly Mimi Oupravanh, DNP - Medicare Nurse Practitioner in Mansfield, MA