Nicole Paige Polimeni, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

019856 Issued in NY

Practice address

4 Kenwood St
Setauket, NY 11733-2048

Phone

(631) 871-1412

NPI assigned

Jul 12, 2016

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 NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: coastalmdintegrativehealthandwellness.nicolepolimeni@155472.advancedmd-direct.com

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.

• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1144672288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 KENWOOD ST",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117332048",
            "telephone_number": "631-871-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 KENWOOD ST",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117332048",
            "telephone_number": "631-871-1412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIMENI",
        "first_name": "NICOLE",
        "middle_name": "PAIGE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-12",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "019856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Collin Patrie, D.D.S.
• Michele Perigaut, PH.D.
• Georgeanna Christina Piazza, LMT
• Nicole J Piervencenti, LMHC
• Allison M Pinard, M.A., ATC, EMT-B
• Kimberly Ann Pope, FNP
• Port Jefferson Chiropractic Office PC
• Port Jefferson Emergency Medical Care (3 Village Family Medicine)
• Jeffrey Porte, M.D.
• Joseph J Pulaski

• Surgical Physician Assistant in Setauket, NY
• Providers in Setauket, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.

Verify at the official NPI Registry.