MR. SAMIR GANDULLA (NPI# 1457698367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457698367 |
| Entity Type | Individual |
| Full Name | MR. SAMIR GANDULLA |
| Practice Address |
12 Methuen St 1st Floor Lawrence MA 01840-1700 |
| Mailing Address |
25 Mount Vernon St Apt. 25 Haverhill MA 01830-6047 |
| Practice Telephone | 9787947966 |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2013-01-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
12 METHUEN ST 1ST FLOOR |
| City | LAWRENCE |
| State | MA |
| Zip Code | 01840-1700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396779401 | Carole Colsell | Social Worker | 12 Methuen St, Lawrence, MA 01840-1700 | 2006-07-11 |
| 1184250441 | Marike Sevigny-morrissey | Counselor | 12 Methuen St, Lawrence, MA 01840-1772 | 2020-03-19 |
| 1316589724 | Michelle M Sharp | Counselor | 12 Methuen St, Lawrence, MA 01840-1772 | 2019-10-17 |
| 1447804786 | Mario Restrepo | Counselor | 12 Methuen St, Lawrence, MA 01840-1772 | 2019-07-25 |
| 1871146266 | Brittany Eargle | Counselor | 12 Methuen St, Lawrence, MA 01840-1772 | 2019-07-24 |
| 1730732371 | Caitlin Agneta | Recreational Therapist Assistant | 12 Methuen St, Lawrence, MA 01840-1772 | 2019-07-23 |
| 1144888603 | Brianna Low Cora | Counselor | 12 Methuen St, Lawrence, MA 01840-1772 | 2019-05-30 |
| 1336705276 | Ashley Spencer | Counselor | 12 Methuen St, Lawrence, MA 01840-1772 | 2019-05-16 |
| 1043772114 | Albert Ndivo | Registered Nurse | 12 Methuen St, Lawrence, MA 01840-1772 | 2019-04-05 |
| 1386117174 | Christine Creegan | Counselor | 12 Methuen St, Lawrence, MA 01840-1700 | 2019-01-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487293569 | Cure-aid Pharmacy Inc | Pharmacy | Cure-aid Pharmacy, 203 Essex Street, Lawrence, MA 01840 | 2020-01-06 |
| 1053819482 | Allied Pharmacy Inc. | Pharmacy | 10-12 Hampshire Street, Lawrence, MA 01840 | 2018-01-31 |
| 1720598626 | Natalie Perez | Counselor | 15 South Union St, 200, Lawrence, MA 01840 | 2017-10-05 |
| 1932636271 | Iluminada De La Cruz | Counselor | 2 Museum Square Apt 412, Lawrence, MA 01840 | 2017-05-17 |
| 1831642867 | Karina Tremiti | Counselor | 599 Canal St, 5th Fl, Lawrence, MA 01840 | 2016-07-26 |
| 1467733717 | Suzanne Beth Macphail | Counselor | 11 Union Street, Lawrence, MA 01840 | 2011-08-31 |
| 1831416767 | Db Practice Management, Inc | Dentist | 488 Essex St, Lawrence, MA 01840 | 2010-05-03 |
| 1033341169 | Michele Davis | Counselor | 15 Union Street, Second Floor, Lawrence, MA 01840 | 2009-08-24 |
| 1447401856 | Erin Grace Mooney | Social Worker | 439 South Union Street, Suite 207a, Lawrence, MA 01840 | 2008-10-03 |
| 1215127840 | Marcia Elaine Nelson-vancini | Nurse Practitioner | Lahey Health Behavioral Services, Inc., 12 Methuen Street, Lawrence, MA 01840 | 2007-07-30 |
| Find all providers in zip 01840 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457981391 | Natasha Mateo-urbaez | Case Manager/Care Coordinator | 360 Merrimack St Bldg 9j3, Lawrence, MA 01843-1740 | 2020-01-20 |
| 1144695065 | Keeleigh Smith | Case Manager/Care Coordinator | 1430 Louisiana St, Apt 10, Lawrence, KS 66044-3428 | 2015-12-03 |
| 1013317130 | Danielle K Dasko | Case Manager/Care Coordinator | 1043 Indiana St Unit 301, Lawrence, KS 66044-2915 | 2014-08-26 |
| 1578989497 | Penny Schuster | Case Manager/Care Coordinator | 21 Weston Pl, Lawrence, NY 11559-1524 | 2014-03-17 |
| 1861816894 | Rivkah Breuer | Case Manager/Care Coordinator | 15 Chestney Rd, Lawrence, NY 11559-2500 | 2014-02-11 |
| 1225395585 | Brandi Leigh Kemper | Case Manager/Care Coordinator | 1919 Delaware St, Lawrence, KS 66046-3173 | 2012-04-11 |
| 1992963599 | Matt J Enyart | Case Manager/Care Coordinator | 4700 Harvard Rd, Lawrence, KS 66049-3734 | 2008-05-30 |
| 1023283165 | Joni Michelle Beard | Case Manager/Care Coordinator | 827 Elm St, Lawrence, KS 66044-5437 | 2008-04-29 |
| 1275701732 | Katie Lynn Zerr | Case Manager/Care Coordinator | 2518 Ridge Ct Ste 238, Lawrence, KS 66046-4061 | 2008-02-18 |
| 1902082878 | Sara Ann Quick | Case Manager/Care Coordinator | 2113 Delaware St, Lawrence, KS 66046-3149 | 2008-01-10 |
| Find all providers in LAWRENCE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.