Nicole Kostarellas, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

3822 Issued in MA

Practice address

103 Garland St
Everett, MA 02149-5066

Phone

(617) 381-7150

NPI assigned

Aug 31, 2009

Last updated

Sep 11, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, 2,931 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brigham and Women's Hospital Hospital, Boston, MA, CCN 220110
• Brigham and Women Faulkner Hospital Hospital, Jamaica Plain, MA, CCN 220119

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

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

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

• Brigham & Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1033535497
  Medicare reassignment Care Compare group NPD
• Brigham and Women's Hospital

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1093885816
  NPD
• Brigham and Womens Physicians Organization Inc

  • Diagnostic Radiology Physician
  • Boston, MA
  • NPI 1265464598
  NPD (past)

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

• Brigham & Womens Hospital, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1790717650
  Care Compare affiliation
• Brigham and Women's Faulkner Hospital Inc

  • Psychiatric Hospital Unit
  • Boston, MA
  • NPI 1033121025
  Care Compare affiliation
• Brigham and Women's Faulkner Hospital Inc

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1578677811
  Care Compare affiliation

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252627200000",
    "number": "1083847628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 GARLAND ST",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021495066",
            "telephone_number": "617-381-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 GARLAND ST",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021495066",
            "telephone_number": "617-381-7150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTARELLAS",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2009-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "3822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Everett, MA
• Providers in Everett, MA by specialty
• Medical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.