Individual provider Active NPI

Jill Ciccariello-Lavigne, NP

  • Family Nurse Practitioner
  • Lawrence, MA
National Provider Identifier
1366994667
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN232612 Issued in MA
Practice address
360 Merrimack St
Lawrence, MA 01843-1740
Phone
(978) 557-8800
Fax
(978) 557-8633
NPI assigned
Nov 3, 2016
Last updated
Jul 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN232612 MA Primary

Addresses

Primary practice location

360 Merrimack St
Lawrence, MA 01843-1740

Mailing address

360 Merrimack St
Lawrence, MA 01843-1740
Phone (978) 557-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 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
I20170315001684 MA Practitioner - Nurse Practitioner 0941585830 Reassigns benefits to 4 organizations
I20230306001517 NH Practitioner - Nurse Practitioner 0941585830

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Operations PCGroup PAC ID 6406141217, 39 clinicians

Practice addresses (Care Compare)

50 Dodge St
Suite 104
Beverly, MA 01915-1765
Phone (978) 922-2171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN232612MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Operations PC CurrentSince Sep 1, 2022 Accepting new patients
Urgent Care Operations, PC CurrentSince Sep 1, 2022 Accepting new patients
Urgent Care Operations PC Current Accepting new patients
Mass General Brigham Community Physicians Inc CurrentSince Feb 5, 2017 Accepting new patients
Afc Physicians of Massachusetts, PC CurrentSince Mar 4, 2022 Accepting new patients
Afc Physicians of Massachusetts CurrentSince Mar 4, 2022 Accepting new patients
Afc Physicians of Massachusetts, PC CurrentSince May 1, 2019 Accepting new patients
Mass General Brigham Community Physicians Inc. CurrentSince Feb 5, 2017 Accepting new patients
Afc Physicians of Massachusetts, PC Current Accepting new patients

Locations

50 Dodge St
Ste 104
Beverly, MA 01915
Phone (978) 922-2171

370 Providence Hwy
Dedham, MA 02026
Phone (781) 461-0200

360 Merrimack St
Lawrence, MA 01843
Phone (978) 557-8800

500 Merrimack St
Lawrence, MA 01843
Phone (978) 557-8800

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

129 Turnpike St
North Andover, MA 01845
Phone (978) 470-0800

371 Broadway
Saugus, MA 01906
Phone (781) 233-1000

415 Cooley St
Unit 3
Springfield, MA 01128
Phone (413) 782-4878

450 Paradise Rd
Swampscott, MA 01907
Phone (781) 581-1327

Organizations & group practices 9

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": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1366994667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 MERRIMACK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431740",
            "telephone_number": "978-557-8800",
            "fax_number": "978-557-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 MERRIMACK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431740",
            "telephone_number": "978-557-8800",
            "fax_number": "978-557-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCARIELLO-LAVIGNE",
        "first_name": "JILL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-03",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN232612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.