Individual provider Active NPI

Hiabella Foggiatto

  • Nurse Practitioner
  • Medford, MA
National Provider Identifier
1417807306
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AG01260068 Issued in MA
Practice address
3920 Mystic Valley Pkwy Apt 717
Medford, MA 02155-6908
Phone
(781) 420-2106
NPI assigned
Jan 30, 2026
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AG01260068 MA Primary
Adult Health Nurse Practitioner 363LA2200X RN2368421 MA

Addresses

Primary practice location

3920 Mystic Valley Pkwy Apt 717
Medford, MA 02155-6908

Mailing address

3920 Mystic Valley Pkwy Apt 717
Medford, MA 02155-6908

Other practice location 1

41 Highland Ave
Winchester, MA 01890-1446
Phone (781) 756-2260

Other practice location 2

200 Unicorn Park Dr Ste 401
Woburn, MA 01801-3342
Phone (781) 756-6760

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260331001496 MA Practitioner - Nurse Practitioner 2466937149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beth Israel Lahey Health Specialty Care, Inc.Group PAC ID 2365405024, 264 clinicians

Practice addresses (Care Compare)

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AG01260068MAMDNurse Practitioner
RN2368421MAMDAdult Health Nurse Practitioner

Organizations & group practices 1

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": "1769731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1417807306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 MYSTIC VALLEY PKWY APT 717",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021556908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 MYSTIC VALLEY PKWY APT 717",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021556908",
            "telephone_number": "781-420-2106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "MA",
            "postal_code": "018901446",
            "country_code": "US",
            "telephone_number": "781-756-2260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Unicorn Park Dr Ste 401",
            "address_purpose": "LOCATION",
            "city": "Woburn",
            "state": "MA",
            "postal_code": "018013342",
            "country_code": "US",
            "telephone_number": "781-756-6760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOGGIATTO",
        "first_name": "HIABELLA",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2026-01-30",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "AG01260068",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2368421",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.