Individual provider Active NPI

Nicholas A Lauricella, PA

  • Physician Assistant
  • Trumbull, CT
National Provider Identifier
1326773151
Registry record updated Jul 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
115 Technology Dr Unit B201
Trumbull, CT 06611-6300
Phone
(203) 545-0139
NPI assigned
Jul 17, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

115 Technology Dr Unit B201
Trumbull, CT 06611-6300

Mailing address

116 Grist Mill Rd
Monroe, CT 06468-1362
Phone (203) 551-0360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220919001104 CT Practitioner - Physician Assistant 3870978471 Reassigns benefits to 3 organizations
I20231207002871 NY Practitioner - Physician Assistant 3870978471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aldad Medical PCGroup PAC ID 9234291436, 78 clinicians

Practice addresses (Care Compare)

263 Tresser Blvd
FL 9
Stamford, CT 06901-3236
Phone (516) 505-7200

27111 76TH Ave
New Hyde Park, NY 11040-1436
Phone (718) 289-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5795CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aldad Medical PC CurrentSince Aug 1, 2023 Accepting new patients

Locations

263 Tresser Blvd
Fl 9
Stamford, CT 06901
Phone (203) 915-8337

510 Hempstead Tpke
Rm 203
West Hempstead, NY 11552
Phone 51650572001051

Interoperability endpoints

  • Direct secure messaging: nick.lauricella@xdr.hhchealthdirect.org

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": "1658016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658016000000",
    "number": "1326773151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 GRIST MILL RD",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064681362",
            "telephone_number": "203-551-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 TECHNOLOGY DR UNIT B201",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066116300",
            "telephone_number": "203-545-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURICELLA",
        "first_name": "NICHOLAS",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-17",
        "last_updated": "2022-07-17",
        "certification_date": "2022-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

Verify at the official NPI Registry.