Individual provider Active NPI

Nicole Tran, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1083432850
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA101135 Issued in MA
Practice address
830 Harrison Avenue
Suite 1400
Boston, MA 02118
Phone
(617) 638-8124
Fax
(617) 414-4953
NPI assigned
Oct 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA101135 MA Primary

Addresses

Primary practice location

830 Harrison Avenue
Suite 1400
Boston, MA 02118

Mailing address

960 Massachusetts Avenue
FL 2
Boston, MA 02118-2690

Other identifiers 2

IdentifierTypeStateIssuer
110216220AMedicaidMA
3148443MedicaidNH

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
I20241218000379 MA Practitioner - Physician Assistant 2769919562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Boston University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bumc Otolaryngologic Foundation IncGroup PAC ID 2163409400, 28 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-8485

830 Harrison Ave
Suite 1400
Boston, MA 02118-2905
Phone (617) 638-8124

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA101135MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients

Locations

960 Massachusetts Ave
Ste 2
Boston, MA 02118

Interoperability endpoints

  • Direct secure messaging: ntran251301@direct.bmc.masshiway.net

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.

Hospital & facility affiliations 8

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": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1083432850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVENUE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 HARRISON AVENUE",
            "address_2": "SUITE 1400",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-638-8124",
            "fax_number": "617-414-4953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-01",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA101135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110216220A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3148443",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.