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MINA R ETEDALI RN
NPI 1679270417
Family Medicine in Danvers, MA

Active since February 13, 2023PECOS Enrolled
66 LIBERTY ST, DANVERS, MA 01923(978) 380-2432 Get Directions Write a Review

NPPES record last updated: April 22, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 22, 2026, Mar 25, 2025, Mar 16, 2025 and 1 more (4 updates tracked since 2023).

About Mina R Etedali Rn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MINA R ETEDALI RN (NPI 1679270417) is an individual family medicine provider in Danvers, Massachusetts, licensed in Massachusetts (RN2356171) and active in the NPI registry since February 2023. She is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1679270417
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameMINA R ETEDALICredential: RN
Location Address66 LIBERTY STDanvers, MA 01923-3323
Mailing Address66 Liberty StDanvers, MA 01923-3323 · (978) 380-2432
Phone(978) 380-2432
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateFebruary 13, 2023
Last NPPES UpdateApril 22, 20264 updates tracked since enumeration
NPPES CertifiedApril 22, 2026
✔ NPI 1679270417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MA · RN2356171
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedRegistered Nurse · Medical-SurgicalTaxonomy 163WM0705X · License 2356171 (MA)
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License RN2356171 (MA)
66 LIBERTY ST, Danvers, MA 01923
Open in Google Maps ↗

Secondary Practice Locations 3

Location 1298 Washington St Fl 4Gloucester, MA 01930-4832 · Phone (978) 283-7580
Location 21400 Vfw PkwyWest Roxbury, MA 02132-4927 · Phone (617) 323-7700
Location 3298 Washington St Fl 1Gloucester, MA 01930-4832 · Phone (978) 283-2726

Other Identifiers 1

OtherRN2356171MA · Rn License Number

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mina R Etedali Rn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8729553359
PECOS Enrollment IDI20260410001232
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01923 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.70 typical visit price
range $58.86 – $177.36
Typical copayment $22.67 (range $14.71 – $44.34)
Most-billed visit code 99203
Established Patient
$103.48 typical visit price
range $19.11 – $144.84
Typical copayment $25.87 (range $4.77 – $36.21)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mina Etedali's NPI number?

The NPI number for Mina Etedali is 1679270417. It was assigned to this individual provider in the NPPES registry on February 13, 2023.

Where is Mina Etedali located?

Mina Etedali practices at 66 Liberty St, Danvers, MA 01923. The listed phone number is (978) 380-2432.

What is Mina Etedali's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Mina Etedali enrolled in Medicare?

Yes. Mina Etedali is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mina Etedali was last updated on April 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.