JUDANA SANDRA BENNETT – Psychiatric/Mental Health Nurse Practitioner, NPI 1073130167
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,971 NURSE PRACTITIONER in MA
Provider Addresses for JUDANA SANDRA BENNETT
46 LAMBERT AVE
ROXBURY, MA 021191766
Phone: (617) 816-6505
Type: Location
909 SUMNER ST
STOUGHTON, MA 020723396
Phone: (781) 222-5530
Type: Mailing
25 James ONeill St
Boston, MA 021274504
Phone: (617) 534-9500
Fax: (617) 419-1706
Type: Location
23 Bradston St
Boston, MA 021182703
Phone: (617) 318-6484
Type: Location
55 FRUIT ST
BOSTON, MA 021142621
Phone: (617) 643-8281
Type: Location
PO BOX 191134
ROXBURY, MA 021190023
Phone: (617) 442-8800
Type: Mailing
45 DIMOCK ST
ROXBURY, MA 021191208
Phone: (617) 816-6505
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $205.
Total Amount is formed as General ($205) + Research ($0) + Ownership ($0) = $205.
Last reported payment date: 2024-11-14 • Largest payer in this snapshot: ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) ($205).
Total Amount
$205
General + Research + Ownership
Payments
3
Total payment records
General Amount
$205
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) | $205 |
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: 2022-07-19
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220719002531 | I | Nurse Practitioner | MA | TBD |
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.
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 02119)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine, Infectious Disease | MA | |
| Internal Medicine, Pediatric Medicine | MA | |
| Physician Assistant | MA | |
| Nurse Practitioner | MA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MA | |
| O P T O M E T R Y | MA | |
| - | MA | |
| Internal Medicine | NY | |
| Clinical Social Worker | MA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MA |
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