HEENA NISSARALY (DNP, RN, AGNP-C) – Nurse Practitioner, NPI 1013890433

HEENA NISSARALY (DNP, RN, AGNP-C) is a healthcare provider. based in Jamaica plain, Massachusetts. specializing in NURSE PRACTITIONER. They hold the professional credentials DNP, RN, AGNP-C. They hold a License No. RN2349337 (MA). The NPI Number for HEENA NISSARALY (DNP, RN, AGNP-C) is 1013890433

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
HEENA NISSARALY (DNP, RN, AGNP-C)
NPI
1013890433
Phone
(617) 763-3518
Address
3297 WASHINGTON ST
Enumeration Date
31 July 2025
Last Update Date
4 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6177326039
Graduation Year
2025 (1 year ago)
PAC ID
8426530270
Group Practice PAC ID
4385554732
Professional Enrollment ID
I20260303000359
Address ID
MA021302655BO3297XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness85
Years active:0State licenses:2Digital endpointsOther names

8,971 NURSE PRACTITIONER in MA

Provider Addresses for HEENA NISSARALY (DNP, RN, AGNP-C)

  • 3297 WASHINGTON ST

    JAMAICA PLAIN, MA 021302655

    Phone: (617) 763-3518

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-03-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20260303000359INurse PractitionerMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02130)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4385554732View full group profile
NameSpecialtyState
Internal MedicineMA
Psychiatry, Pediatric MedicineMA
Nurse PractitionerMA
Internal Medicine, Infectious DiseaseMA
-NH
Nurse PractitionerMA
-MA
Certified Nurse Midwife (Cnm)NH
Internal MedicineMA
Nurse PractitionerMA

Reviews

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Frequently asked questions

How do payers reference HEENA NISSARALY (DNP, RN, AGNP-C)?
For HEENA NISSARALY (DNP, RN, AGNP-C), use NPI 1013890433 as the unique 10-digit identifier.
Is HEENA NISSARALY (DNP, RN, AGNP-C) shown as active in public data?
Registry records indicate HEENA NISSARALY (DNP, RN, AGNP-C) maintains an active NPI.
What area of care is associated with HEENA NISSARALY (DNP, RN, AGNP-C)?
HEENA NISSARALY (DNP, RN, AGNP-C)'s record emphasizes Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for HEENA NISSARALY (DNP, RN, AGNP-C)?
Travel planning: use Jamaica Plain, Massachusetts as the reference point for HEENA NISSARALY (DNP, RN, AGNP-C), then confirm.
When was this NPI issued?
Enumeration for HEENA NISSARALY (DNP, RN, AGNP-C) is noted as July 31, 2025 where the registry provides it.

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