Anthony Peter Nicosia, M.D.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

ME91689 Issued in FL

Practice address

1502 SE Holiday Rd
Port Saint Lucie, FL 34952-5416

Phone

(772) 332-1757

Fax

(772) 777-3044

NPI assigned

Oct 26, 2006

Last updated

Oct 27, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Anthony P. Nicosia MD LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Port St Lucie, FL
  • NPI 1043589187

  Adult Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1396820668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8540",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349858540",
            "telephone_number": "772-332-1757",
            "fax_number": "772-777-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 SE HOLIDAY RD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349525416",
            "telephone_number": "772-332-1757",
            "fax_number": "772-777-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOSIA",
        "first_name": "ANTHONY",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME91689",
            "primary": false
        },
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "FL",
            "license": "ME91689",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "ME91689",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME91689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278035600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0940704",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kami Nichols
• Melinda (Mindy) Nichols
• Michele Renee Nichols
• Nicole Sconzo Enterprises LLC
• Nicole Vendette, LLC (The Collaborative Behavior Group)
• Breana Nicotra, MS
• Rozeta Nikolova
• Summer Nicole Niles
• Jasmine Noel
• Kettia Noel

• Geriatric Medicine (Family Medicine) Physician in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Geriatric Medicine (Family Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.