MEDICARE: NEW RISE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1134093354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW RISE LLC

Provider Business Mailing Address
First Line	:	200 E MOUNTAIN ST APT 192
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01606-1222
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 E MOUNTAIN ST APT 192
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01606-1222
Country	:	US
Telephone Number	:	401-548-8759
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ PRESIDENT
Name	:	MARIO VAZ
Credential	:
Telephone Number	:	401-548-8759

Provider Enumeration Date	:	10/01/2025
Last Update Date	:	10/01/2025

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Directions to “NEW RISE LLC ” Practice Location

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