Bridgecare Provider Group Ma, PLLC
NPI 1679366298ActiveOrganization· Nurse Practitioner· Concord, MA
Nurse Practitioner in Concord, Massachusetts, registered in NPPES in May 2025. The authorized official on file is Marivic Vanover (Jed) Vanover, NURSE PRACTITIONER, Vice President Of Operation. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1679366298 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 27, 2025 |
| Last updated in NPPES | May 27, 2025 |
| Certified by provider | May 27, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MA) |
|---|
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