NPIMap

Individual provider Active NPI

Nicole Marie Osevala, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Hershey, PA
National Provider Identifier
1205953015
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
MD436859 Issued in PA
Practice address
1120 Cocoa Ave
Hershey, PA 17033
Phone
(717) 533-4141
Fax
(717) 533-9797
NPI assigned
Mar 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD436859 PA
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MD436859 PA Primary

Addresses

Primary practice location

1120 Cocoa Ave
Hershey, PA 17033

Mailing address

P.O. Box 858
Ca410
Hershey, PA 17033-0858
Phone (800) 243-1455

Other practice location 1

500 University Dr
Hershey, PA 17033-2360
Phone (800) 233-4082

Other practice location 2

1135 Olde W Chocolate Ave
Hummelstown, PA 17036-9188
Phone (800) 243-1455

Other practice location 3

2501 N 3rd St
Harrisburg, PA 17110-1904
Phone (717) 782-6420

Other identifiers 1

IdentifierTypeStateIssuer
1023075470002MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nosevala@direct.psu.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090624000471 PA Practitioner - Geriatric MedicinePractitioner - Internal Medicine 7618060849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Pennsylvania State University College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

500 Universidy Dr
Hershey, PA 17033-2360
Phone (717) 531-6754

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
56.69
Promoting interoperability
100
Improvement activities
40
Cost
74.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physician Group CurrentSince Aug 4, 2010 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Internal Medicine CurrentSince Aug 4, 2010 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
Alpine Valley Operator LLC Past Accepting new patients
900 Tuck Street Operations LLC Past Accepting new patients
Masonic Villages of the Grand Lodge of Pennsylvania Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

2501 N 3rd St
Harrisburg, PA 17110
Phone (717) 782-2100

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

1135 Olde W Chocolate Ave
Hummelstown, PA 17036
Phone (717) 531-7010

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Courtyard Gardens Nursing and RehabilitationMiddletown, PA, CCN 395518 Skilled nursing facility Adp of the SNF Apr 29, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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.

Hospital & facility affiliations 8

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": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1205953015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 858",
            "address_2": "CA410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 COCOA AVE",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "17033",
            "telephone_number": "717-533-4141",
            "fax_number": "717-533-9797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "800-233-4082",
            "fax_number": "717-531-7269",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1135 Olde W Chocolate Ave",
            "address_purpose": "LOCATION",
            "city": "Hummelstown",
            "state": "PA",
            "postal_code": "170369188",
            "country_code": "US",
            "telephone_number": "800-243-1455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2501 N 3rd St",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171101904",
            "country_code": "US",
            "telephone_number": "717-782-6420",
            "fax_number": "717-782-4727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSEVALA",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-25",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD436859",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "PA",
            "license": "MD436859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023075470002",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nosevala@direct.psu.edu",
            "affiliation": "N",
            "endpointDescription": "direct email",
            "address_1": "1120 Cocoa Ave",
            "city": "Hershey",
            "state": "PA",
            "country_code": "US",
            "postal_code": "17033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.