Nicole Izzo, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

5137 Issued in MA

Practice address

800 Washington St # 1013
Pratt Neurosurgery Associates, Inc
Boston, MA 02111-1552

Phone

(617) 636-5000

NPI assigned

Aug 28, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole Comosa Former name

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New England Medical Center Group Practice IncGroup PAC ID 4789647405, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tufts Medical Center Hospital, Boston, MA, CCN 220116

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: nizzo29715@tuftsmedicine.direct-ci.com

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.

• New England Medical Center Group Practice Inc

  • Neurological Surgery Physician
  • Boston, MA
  • NPI 1487601787
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tufts Medical Center, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1730132515
  Care Compare affiliation

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497830400000",
    "number": "1427458348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST # 1013",
            "address_2": "PRATT NEUROSURGERY ASSOCIATES, INC",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST # 1013",
            "address_2": "PRATT NEUROSURGERY ASSOCIATES, INC",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZZO",
        "first_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-28",
        "last_updated": "2017-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "5137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "COMOSA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Azade Izadi, M.D.
• Aaron Izenberg, MD
• Mitchell Izower, BS, MD
• Louis Izzi
• Michael Carmine Izzo, LCSW
• Victoria Izzo, LMHC
• Saef Izzy, M.D.
• J. Wallace McMeel, M.D., P.C.
• J.Edmond LLC
• J.L Smith Suicide Prevention Center for Young Black Boys Inc

• Surgical Physician Assistant in Boston, MA
• Providers in Boston, MA by specialty
• Surgical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.