Individual provider Active NPI

Nadia Tikhomirova, NP

  • Family Nurse Practitioner
  • Acton, MA
National Provider Identifier
1023367356
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2263046 Issued in MA
Practice address
321 Main St
Acton, MA 01720-3799
Phone
(978) 635-8700
NPI assigned
Aug 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2263046 MA Primary

Addresses

Primary practice location

321 Main St
Acton, MA 01720-3799

Mailing address

321 Main St
Acton, MA 01720-3799
Phone (978) 635-8700

Other identifiers 1

IdentifierTypeStateIssuer
1310097MedicaidMA

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
I20121126000465 MA Practitioner - Nurse Practitioner 6608027503 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acton Medical Associates, PC CurrentSince Mar 4, 2019 Accepting new patients
Bayon Medical Group LLC PastSince Apr 16, 2023 Accepting new patients

Locations

45 Discovery Way
Acton, MA 01720

321 Main St
Acton, MA 01720
Phone (978) 263-1131

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FIBBCD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1346371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1023367356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 MAIN ST",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017203799",
            "telephone_number": "978-635-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 MAIN ST",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017203799",
            "telephone_number": "978-635-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIKHOMIROVA",
        "first_name": "NADIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-31",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2263046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1310097",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Acton, MA

Sources for this page

Verify at the official NPI Registry.