Individual provider Active NPI

Nicole Carretta Phalen, RN

  • Family Nurse Practitioner
  • Holyoke, MA
National Provider Identifier
1164091963
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2353271 Issued in MA
Practice address
230 Maple St Ste 1
Holyoke, MA 01040-5140
Phone
(413) 420-2200
NPI assigned
Jun 24, 2021
Last updated
Jan 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 163883 CT
Registered Nurse 163W00000X RN2353271 MA
Family Nurse Practitioner 363LF0000X RN2353271 MA Primary

Addresses

Primary practice location

230 Maple St Ste 1
Holyoke, MA 01040-5140

Mailing address

230 Maple St Ste 1
Holyoke, MA 01040-5140

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL NextGen Direct Holyoke Health Center, Inc.

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
I20210917000338 MA Practitioner - Nurse Practitioner 2163829151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holyoke Health Center Inc.Group PAC ID 8527969302, 40 clinicians

Practice addresses (Care Compare)

230 Maple St
Holyoke, MA 01040-5144
Phone (413) 420-2200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
163883CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Holyoke Health Center Inc. CurrentSince Aug 30, 2021 Accepting new patients
Chicopee Health Center Pharmacy CurrentSince Aug 30, 2021 Accepting new patients
Holyoke Health Center Inc. PastSince Jun 27, 2021 Accepting new patients
Holyoke Health Center Inc. Past Accepting new patients

Locations

505 Front St
Chicopee, MA 01013
Phone (413) 420-2222

230 Maple St
Holyoke, MA 01040
Phone (413) 322-7380

230 Maple St
Ste 1
Holyoke, MA 01040
Phone (413) 420-6210

Interoperability endpoints

  • Direct secure messaging: nphalen20507@direct.ctc.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.

Hospital & facility affiliations 1

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": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1164091963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 MAPLE ST STE 1",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010405140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MAPLE ST STE 1",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010405140",
            "telephone_number": "413-420-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHALEN",
        "first_name": "NICOLE",
        "middle_name": "CARRETTA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-24",
        "last_updated": "2022-01-25",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "163883",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2353271",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2353271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NextGen",
            "affiliation": "Y",
            "endpointDescription": "EMR",
            "affiliationName": "Holyoke Health Center, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EMR",
            "address_1": "230 Maple St Ste 1",
            "city": "Holyoke",
            "state": "MA",
            "country_code": "US",
            "postal_code": "010405140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Holyoke, MA

Sources for this page

Verify at the official NPI Registry.