Individual provider Active NPI

Nicole Massina

  • Specialist
  • Oakdale, NY
National Provider Identifier
1205598265
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
21 Race PL
Oakdale, NY 11769-1705
Phone
(631) 708-5663
NPI assigned
Oct 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

21 Race PL
Oakdale, NY 11769-1705

Mailing address

21 Race PL
Oakdale, NY 11769-1705
Phone (631) 708-5663

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1205598265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 RACE PL",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691705",
            "telephone_number": "631-708-5663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 RACE PL",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691705",
            "telephone_number": "631-708-5663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSINA",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.