Individual provider Active NPI

Ana Nectara Ticlea, MD

  • Psychiatry Physician
  • Brockton, MA
National Provider Identifier
1295986164
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
246371 Issued in MA
Practice address
940 Belmont St
Brockton, MA 02301-5596
Phone
(774) 826-1785
NPI assigned
Oct 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 246371 MA Primary

Addresses

Primary practice location

940 Belmont St
Brockton, MA 02301-5596

Mailing address

940 Belmont St
Brockton, MA 02301-5596
Phone (774) 826-1785

Other names 1

  • Ana N Ratusca Former name

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
I20110802000807 MA Practitioner - Psychiatry 1052366184 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The McLean Hospital CorporationGroup PAC ID 9436040961, 186 clinicians

Practice addresses (Care Compare)

115 Mill St
Belmont, MA 02478-1064
Phone (617) 855-3450

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
246371MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The McLean Hospital Corporation Psychiatry CurrentSince Jun 20, 2014 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince May 20, 2013 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince May 20, 2013 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince May 20, 2013 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Psychiatry CurrentSince May 20, 2013 Accepting new patients
The McLean Hospital Corporation Past Accepting new patients

Locations

115 Mill St
Belmont, MA 02478
Phone (617) 855-2000

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

940 Belmont St
Brockton, MA 02301
Phone (774) 826-1106

23 Isaac St
Middleboro, MA 02346
Phone (774) 419-1000

1 University Ave
Westwood, MA 02090
Phone (617) 754-1021

Interoperability endpoints

  • Direct secure messaging: ticlea.ana.mcl@direct.partners.masshiway.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1295986164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 BELMONT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015596",
            "telephone_number": "774-826-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 BELMONT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015596",
            "telephone_number": "774-826-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICLEA",
        "first_name": "ANA",
        "middle_name": "NECTARA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "246371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANA",
            "last_name": "RATUSCA",
            "middle_name": "N",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.