Individual provider Active NPI

John Nathanael Nollet, PA-C

  • Medical Physician Assistant
  • Fall River, MA
National Provider Identifier
1013605419
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
363 Highland Ave
Fall River, MA 02720-3703
Phone
(508) 679-3131
NPI assigned
Apr 25, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

363 Highland Ave
Fall River, MA 02720-3703

Mailing address

62 Carteret St
Providence, RI 02908-1513
Phone (860) 833-0867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230620002807 MA Practitioner - Physician Assistant 4385002567 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobilehealth Wound Care LLCGroup PAC ID 5890281927, 4 clinicians

Practice addresses (Care Compare)

16 Hill Creek Rd
Centerville, MA 02632-3365
Phone (508) 292-4270

Hospital & facility affiliations

  • Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mobilehealth Wound Care LLC CurrentSince Dec 17, 2025 Accepting new patients
MHWC LLC PastSince Dec 17, 2025 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1013605419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 CARTERET ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029081513",
            "telephone_number": "860-833-0867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 HIGHLAND AVE",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027203703",
            "telephone_number": "508-679-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLLET",
        "first_name": "JOHN",
        "middle_name": "NATHANAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.