Active NPI
Pamela H Ciccone, N.P.
- Nurse Practitioner
- Woburn, MA
National Provider Identifier
1184768178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 172715
- Practice address
- 4 Blossom St
Woburn, MA 01801-5106 - Phone
- (781) 305-3237
- NPI assigned
- Feb 16, 2007
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 172715 | MA | Primary |
Addresses
Primary practice location
4 Blossom St
Woburn, MA 01801-5106
Mailing address
4 Blossom St
Woburn, MA 01801-5106
Phone (781) 305-3237
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, NH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 172715 | MA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Matrix Medical Plus | Nurse Practitioner | Current | Accepting new patients |
| Community Care Health Network LLC | Nurse Practitioner | Current | Accepting new patients |
Locations
9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883
3 Allied Dr
Dedham, MA 02026
Phone (404) 587-0945
1 Tara Blvd
Ste 200
Nashua, NH 03062
Phone (603) 242-2296
Organizations & group practices 2
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": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431993600000",
"number": "1184768178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 BLOSSOM ST",
"city": "WOBURN",
"state": "MA",
"postal_code": "018015106",
"telephone_number": "781-305-3237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 BLOSSOM ST",
"city": "WOBURN",
"state": "MA",
"postal_code": "018015106",
"telephone_number": "781-305-3237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CICCONE",
"first_name": "PAMELA",
"middle_name": "H",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-16",
"last_updated": "2015-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "172715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woburn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.