MINA R ETEDALI RN
NPI 1679270417
Family Medicine in Danvers, MA
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, is affiliated with Northeast Hospital Corporation, and maintains 3 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 3
Secondary Practice Locations 3
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mina R Etedali Rn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Mina Etedali reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Beverly, MA 01915
- Reassigned Medicare billing, Massachusetts enrollment
- 410 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Northeast Hospital Corporation
Acute Care Hospitals · Beverly, MAPhysician 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.
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 system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Mina Etedali's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mina Etedali reassigns Medicare benefits to Beth Israel Lahey Health Primary Care, Inc. (Beverly, MA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mina Etedali's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Mina Etedali affiliated with any hospitals?
According to CMS data, Mina Etedali is affiliated with Northeast Hospital Corporation.
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 6 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.
# Mina R Etedali, RN · NPI 1679270417
Family Medicine physician in Danvers, Massachusetts. Individual provider, active in the CMS NPPES registry since February 13, 2023.
## Identity
- **NPI:** 1679270417 (Entity type: Individual)
- **Enumerated:** February 13, 2023
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** RN2356171 (Massachusetts)
- **Sole proprietor:** No
## Practice location
- **Address:** 66 LIBERTY ST, Danvers, MA 01923-3323
- **Phone:** (978) 380-2432
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Beth Israel Lahey Health Primary Care, Inc. (NPI 1508244195, Beverly, MA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** April 22, 2026
- **Other identifiers:** Other RN2356171 (MA)
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Source: [NPI Profile](https://npiprofile.com/npi/1679270417) · Data from the CMS NPPES public registry.