Active NPI
Nicole Medeiros, PA-C
- Medical Physician Assistant
- Auburndale, MA
National Provider Identifier
1104161330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA4553
- Practice address
- 85 Crescent St Apt 1
Auburndale, MA 02466-2509 - Phone
- (781) 215-1788
- NPI assigned
- Nov 28, 2012
- Last updated
- Jan 9, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA4553 | MA | Primary |
Addresses
Primary practice location
85 Crescent St Apt 1
Auburndale, MA 02466-2509
Mailing address
85 Crescent St Apt 1
Auburndale, MA 02466-2509
Phone (781) 215-1788
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Afc Physicians of Massachusetts, PC | Current | Accepting new patients | |
| Newton Wellesley Hospital | Current | Accepting new patients |
Locations
945 Worcester St
Natick, MA 01760
Phone (508) 650-6208
2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000
Interoperability endpoints
- medeiros.nicole.nwh@direct.partners.masshiway.net
Organizations & group practices 4
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.
-
- Emergency Medicine Physician
- Newton, MA
- NPI 1346355526
-
dba Afc Urgent Care
- Urgent Care Clinic/Center
- Marlborough, MA
- NPI 1952715419
-
- General Acute Care Hospital
- Newton, MA
- NPI 1952845521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420761600000",
"number": "1104161330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 CRESCENT ST APT 1",
"city": "AUBURNDALE",
"state": "MA",
"postal_code": "024662509",
"telephone_number": "781-215-1788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 CRESCENT ST APT 1",
"city": "AUBURNDALE",
"state": "MA",
"postal_code": "024662509",
"telephone_number": "781-215-1788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDEIROS",
"first_name": "NICOLE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-28",
"last_updated": "2015-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MA",
"license": "PA4553",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburndale, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.