Active NPI
Robert Joseph Nicoletta Jr., M.D.
- Sports Medicine (Orthopaedic Surgery) Physician
- Boston, MA
National Provider Identifier
1194705616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- 212596
- Practice address
- 725 Albany St
Shapiro 4, Suite B
Boston, MA 02118-2526 - Phone
- (617) 638-5633
- Fax
- (617) 414-5226
- NPI assigned
- Jan 19, 2006
- Last updated
- May 21, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 212596 | MA | Primary |
| Orthopaedic Surgery Physician | 207X00000X | 212596 | MA |
Addresses
Primary practice location
725 Albany St
Shapiro 4, Suite B
Boston, MA 02118-2526
Mailing address
720 Harrison Ave
Dob 503
Boston, MA 02118-2371
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Sports Medicine
- Education
- State University of Ny Upstate Medical University, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
725 Albany St
Boston, MA 02118-2526
Phone (617) 638-5633
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 32 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 212596 | MA | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boston Medical Center Corporation | Current | Accepting new patients | |
| Boston University Family Medicine, Inc. | Past | Accepting new patients |
Locations
1 Boston Medical Ctr Pl
Roxbury, MA 02118
Phone (617) 414-5245
Interoperability endpoints
- rnicoletta11503@direct.bmc.masshiway.net
Organizations & group practices 3
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.
-
- Orthopaedic Surgery Physician
- Boston, MA
- NPI 1164460580
-
- General Acute Care Hospital
- Boston, MA
- NPI 1346218294
-
- Family Medicine Physician
- Boston, MA
- NPI 1134166390
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Transitional Care Center and Stabilization Care Center
- General Acute Care Hospital
- Boston, MA
- NPI 1164177028
-
dba South Boston Community Health Center
- Community Health Clinic/Center
- South Boston, MA
- NPI 1225228679
Hospital
-
- General Acute Care Hospital
- Boston, MA
- NPI 1346218294
-
dba Greater Roslindale Medical and Dental Center
- Community Health Clinic/Center
- Roslindale, MA
- NPI 1386718823
Hospital
-
dba Dorchester House Multi Service Center
- Community Health Clinic/Center
- Dorchester, MA
- NPI 1780874677
Hospital
-
dba East Boston Neighborhood Health Center
- Community Health Clinic/Center
- East Boston, MA
- NPI 1861683518
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400630400000",
"number": "1194705616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 HARRISON AVE",
"address_2": "DOB 503",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 ALBANY ST",
"address_2": "SHAPIRO 4, SUITE B",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182526",
"telephone_number": "617-638-5633",
"fax_number": "617-414-5226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICOLETTA",
"first_name": "ROBERT",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-19",
"last_updated": "2014-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "MA",
"license": "212596",
"primary": true
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MA",
"license": "212596",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.