Individual provider Active NPI

Nicoleta Coconcea, M.D.

  • Psychiatry Physician
  • Wilmington, DE
National Provider Identifier
1285729624
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C1-0011919 Issued in DE
Practice address
5700 Kirkwood Hwy Ste 107
Wilmington, DE 19808
Phone
(302) 224-1711
Fax
(302) 513-9967
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 233961 MA
Geriatric Psychiatry Physician 2084P0805X 35-074735 OH
Psychiatry Physician 2084P0800X C1-0011919 DE Primary

Addresses

Primary practice location

5700 Kirkwood Hwy Ste 107
Wilmington, DE 19808

Mailing address

120 Spice Mill LN
Wilmington, DE 19808-3300
Phone (617) 763-7093

Other practice location 1

115 Mill St
Belmont, MA 02478-1064
Phone (617) 855-2985

Other identifiers 1

IdentifierTypeStateIssuer
364031MedicaidOH

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071103000058 MA Practitioner - Psychiatry 8123091774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hallmark Health Medical Associates IncGroup PAC ID 4385638782, 151 clinicians

Practice addresses (Care Compare)

101 Main St
Medford, MA 02155-4530
Phone (781) 338-7270

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-074735OHMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Psychiatry, LLC Psychiatry CurrentSince Jul 15, 2019 Accepting new patients
Hallmark Health Medical Associates Inc CurrentSince Feb 1, 2024 Accepting new patients
Christiana Care Health Services Inc Past Accepting new patients
Christiana Care Health Services, Inc Past Accepting new patients

Locations

5700 Kirkwood Hwy
Ste 107
Wilmington, DE 19808
Phone (302) 224-1711

101 Main St
Ste 112
Medford, MA 02155
Phone (781) 338-7270

425 Revere St
Revere, MA 02151
Phone (781) 286-1313

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/5c7467fb-60f9-4172-add4-57667a5dfcfa/
  • Direct secure messaging: ncoconcea107254@tuftsmedicine.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1285729624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 SPICE MILL LN",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198083300",
            "telephone_number": "617-763-7093",
            "fax_number": "617-507-3482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 KIRKWOOD HWY STE 107",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19808",
            "telephone_number": "302-224-1711",
            "fax_number": "302-513-9967"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Mill St",
            "address_purpose": "LOCATION",
            "city": "Belmont",
            "state": "MA",
            "postal_code": "024781064",
            "country_code": "US",
            "telephone_number": "617-855-2985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COCONCEA",
        "first_name": "NICOLETA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "233961",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "OH",
            "license": "35-074735",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DE",
            "license": "C1-0011919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "364031",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.