Individual provider Active NPI

Lucette Nadle, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Westborough, MA
National Provider Identifier
1104880483
Registry record updated Aug 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
55679 Issued in MA
Practice address
160 E Main St
Ste 1E
Westborough, MA 01581-1758
Phone
(508) 366-9686
Fax
(508) 366-9435
NPI assigned
Apr 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 55679 MA Primary

Addresses

Primary practice location

160 E Main St
Ste 1E
Westborough, MA 01581-1758

Mailing address

160 E Main St
Ste 1E
Westborough, MA 01581-1758
Phone (508) 366-9686

Other identifiers 4

IdentifierTypeStateIssuer
722313OtherMATUFTS HEALTH PLAN
AA6781OtherMAHARVARD PILGRIM HEALTHCAR
9731041MedicaidMA
J08035OtherMABLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55679MAMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lucette Nadle DO Neuromusculoskeletal Medicine & Omm PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 1

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217548800000",
    "number": "1104880483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E MAIN ST",
            "address_2": "STE 1E",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015811758",
            "telephone_number": "508-366-9686",
            "fax_number": "508-366-9435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E MAIN ST",
            "address_2": "STE 1E",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015811758",
            "telephone_number": "508-366-9686",
            "fax_number": "508-366-9435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADLE",
        "first_name": "LUCETTE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2008-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MA",
            "license": "55679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "722313",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "AA6781",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9731041",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "J08035",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.