NPIMap

Individual provider Active NPI

Nicole A. Wood, MD

  • Family Medicine Physician
  • Pembroke, MA
National Provider Identifier
1053398040
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
213942 Issued in MA
Practice address
28 Riverside Dr
Pembroke, MA 02359-1937
Phone
(781) 826-8065
Fax
(781) 826-8043
NPI assigned
Dec 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 213942 MA Primary
Family Medicine Physician 207Q00000X 282769 NY
Family Medicine Physician 207Q00000X MD15206 RI
Family Medicine Physician 207Q00000X MD20820 ME

Addresses

Primary practice location

28 Riverside Dr
Pembroke, MA 02359-1937

Mailing address

28 Riverside Dr
Pembroke, MA 02359-1937
Phone (781) 826-8065

Other identifiers 4

IdentifierTypeStateIssuer
0180327MedicaidMA
713569OtherMAHARVARD PILGRIM
213942OtherMATUFTS HEALTH PLAN
J25178OtherMABLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100927000927 MA Practitioner - Family Practice 3476679507 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Massachusetts Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
Harbor Medical Associates IncGroup PAC ID 2466356209, 130 clinicians

Practice addresses (Care Compare)

15 Corporate Park Dr
Pembroke, MA 02359-1966
Phone (781) 826-8065

2014 Washington St
Newton, MA 02462-1607
Phone (617) 243-6000

2600 Compass Rd
Glenview, IL 60026-8001

541 Main St
Suite 400
South Weymouth, MA 02190-1889
Phone (781) 952-1200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD20820MEMDFamily Medicine Physician
282769NYMDFamily Medicine Physician
MD15206RIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Medical Associates, Inc. CurrentSince Jun 27, 2002 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
Harbor Medical Associates, Inc. Family Medicine CurrentSince Jun 27, 2002 Accepting new patients
Mass General Brigham Medical Group Suburban Massachusetts Inc Family Medicine CurrentSince Jan 1, 2026 Accepting new patients

Locations

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

28 Riverside Dr
Pembroke, MA 02359
Phone (781) 248-3730

15 Corporate Park Dr
Pembroke, MA 02359
Phone (781) 826-8065

541 Main St
Ste 314
Weymouth, MA 02190
Phone (781) 952-1200

541 Main St
Ste 400
Weymouth, MA 02190
Phone (781) 340-0100

Interoperability endpoints

  • Direct secure messaging: wood.nicole.bwh@direct.partners.masshiway.net

Organizations & group practices 5

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 9

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453852800000",
    "number": "1053398040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 RIVERSIDE DR",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "023591937",
            "telephone_number": "781-826-8065",
            "fax_number": "781-826-8043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 RIVERSIDE DR",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "023591937",
            "telephone_number": "781-826-8065",
            "fax_number": "781-826-8043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "NICOLE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2016-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "213942",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "282769",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD15206",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD20820",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0180327",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "713569",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "213942",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J25178",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke, MA

Sources for this page

Verify at the official NPI Registry.