Nicole Modzelewski

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

125 Parker Hill Ave Ste 2
Boston, MA 02120-2865

Phone

(617) 754-5000

NPI assigned

Jun 22, 2021

Last updated

Jun 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Am Medical PCGroup PAC ID 9133451990, 14 clinicians

Geriatric Primary Care PCGroup PAC ID 7315483583, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baystate Wing Hospital Hospital, Palmer, MA, CCN 220030
• Baystate Medical Center Hospital, Springfield, MA, CCN 220077
• Cooley Dickinson Hospital Inc,the Hospital, Northampton, MA, CCN 220015

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: nmodzelewski252446@direct.bilh.masshiway.net

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.

• Am Medical PC

  • Internal Medicine Physician
  • Agawam, MA
  • NPI 1104476613
  Medicare reassignment Care Compare group
• Geriatric Primary Care PC

  • Internal Medicine Physician
  • Agawam, MA
  • NPI 1972349090
  Medicare reassignment Care Compare group
• New England Baptist Medical Associates, Inc.

  • Internal Medicine Physician
  • Roxbury Crossing, MA
  • NPI 1609854991
  Medicare reassignment
• Neb Radiology PC

  • Diagnostic Radiology Physician
  • Roxbury Crossing, MA
  • NPI 1073590840

  Single Specialty

  NPD (past)

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

• Baystate Medical Center Inc

  dba Baystate Medical Center

  • General Acute Care Hospital
  • Springfield, MA
  • NPI 1487655064
  Care Compare affiliation
• Baystate Medical Center Inc

  dba Baystate Reference Laboratories

  • Clinical Medical Laboratory
  • Springfield, MA
  • NPI 1568488450

  Hospital

  Care Compare affiliation
• Baystate Wing Hospital Corporation

  dba Baystate Wing Hospital & Medical Centers

  • General Acute Care Hospital
  • Palmer, MA
  • NPI 1962410233
  Care Compare affiliation
• Cooley Dickinson Hospital Inc

  • General Acute Care Hospital
  • Northampton, MA
  • NPI 1477596310
  Care Compare affiliation
• Cooley Dickinson Hospital Inc

  • Psychiatric Hospital Unit
  • Northampton, MA
  • NPI 1871512814
  Care Compare affiliation

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1508435884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 DELANEY AVE",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010131311",
            "telephone_number": "413-426-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PARKER HILL AVE STE 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021202865",
            "telephone_number": "617-754-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "153 Delaney Ave",
            "address_purpose": "LOCATION",
            "city": "Chicopee",
            "state": "MA",
            "postal_code": "010131311",
            "country_code": "US",
            "telephone_number": "413-426-3651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MODZELEWSKI",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mora Modisette, PT
• Gita Natwar Mody, M.D.
• Janvi Mody
• Karan Mody, MD
• Katherine L. Modzelewski, MD
• Monica Moeller, PA-C
• Michael A Moffat, MD
• Patricia H Moffatt, MD
• Amanda Moffettone, LCSW, LICSW
• Kristin Leigh Moffitt, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.