| Cassandra Theodoris, NP | |
|
110 Liberty St, Brockton, MA 02301-5521 | |
| (508) 894-0400 | |
| Not Available |
| Full Name | Cassandra Theodoris |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 6 Years |
| Location | 110 Liberty St, Brockton, Massachusetts |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316411481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | RN2312573 (Massachusetts) | Secondary |
| 363LA2100X | Nurse Practitioner - Acute Care | RN2312573 (Massachusetts) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lahey Hospital & Medical Center, Burlington | Burlington, MA | Hospital |
| Northeast Hospital Corporation | Beverly, MA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lahey Clinic Inc | 2264336528 | 1200 |
| Entity Name | Lahey Clinic Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538194980 PECOS PAC ID: 2264336528 Enrollment ID: O20031120000097 |
| Entity Name | Lahey Clinic Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063447316 PECOS PAC ID: 2264336528 Enrollment ID: O20040629001269 |
| Mailing Address | Practice Location Address |
|---|---|
| Cassandra Theodoris, NP 1440 Eastern Ave, Malden, MA 02148-6112 Ph: () - | Cassandra Theodoris, NP 110 Liberty St, Brockton, MA 02301-5521 Ph: (508) 894-0400 |
Christine Nichole Lattuada, PNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1 Pearl St, Suite 2000, Brockton, MA 02301 Phone: 508-894-8577 Fax: 508-894-8578 | |
Rebecca Match, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 20 Meadowbrook Rd, Brockton, MA 02301 Phone: 508-638-6006 | |
Jessica Santiccioli, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 63 Main St, Brockton, MA 02301 Phone: 508-559-6699 | |
Nnemeka A Okpala, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 529 Pearl St, Brockton, MA 02301 Phone: 617-922-4626 | |
Mrs. Henrietta Amaka Ewuzie, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 14 Heritage Ct, Brockton, MA 02302 Phone: 857-233-1890 | |
Mrs. Rena B Levy, MSN, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 110 Liberty St, Brockton, MA 02301 Phone: 508-894-0400 Fax: 508-894-0412 | |
Lauren Kaplan, CPNP-PC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1324 Belmont St Ste 105, Brockton, MA 02301 Phone: 617-571-6732 |