Active NPI
Nicole J Paulson, PA-C
- Physician Assistant
- Brockton, MA
National Provider Identifier
1598035479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA4323
- Practice address
- 1350 Belmont St
Suite 102
Brockton, MA 02301 - Phone
- (774) 776-2991
- Fax
- (747) 776-2996
- NPI assigned
- Jan 9, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA4323 | MA | Primary |
Addresses
Primary practice location
1350 Belmont St
Suite 102
Brockton, MA 02301
Mailing address
960 Massachusetts Ave
FL 2
Boston, MA 02118-2690
Other practice location 1
1 Pearl St
Suite 2000
Brockton, MA 02301
Phone (508) 584-4104
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110125684A | Medicaid | MA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
235 N Pearl St
Brockton, MA 02301-1794
Phone (508) 427-3000
Hospital & facility affiliations
- Good Samaritan Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA4323 | MA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steward Medical Group, Inc | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FEDICA/Endpoint/FEDICA
- nicole.paulson.2@2017.direct.athenahealth.com
- npaulson259790@direct.bmc.masshiway.net
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Boston, MA
- NPI 1245320910
-
- Specialist
- Brighton, MA
- NPI 1356654495
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Brockton, MA
- NPI 1871329110
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771545600000",
"number": "1598035479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "960 MASSACHUSETTS AVE",
"address_2": "FL 2",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 BELMONT ST",
"address_2": "SUITE 102",
"city": "BROCKTON",
"state": "MA",
"postal_code": "02301",
"telephone_number": "774-776-2991",
"fax_number": "747-776-2996"
}
],
"practiceLocations": [
{
"address_1": "1 Pearl St",
"address_2": "Suite 2000",
"address_purpose": "LOCATION",
"city": "Brockton",
"state": "MA",
"postal_code": "02301",
"country_code": "US",
"telephone_number": "508-584-4104",
"fax_number": "508-584-4105",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PAULSON",
"first_name": "NICOLE",
"middle_name": "J",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-09",
"last_updated": "2026-02-20",
"certification_date": "2026-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "PA4323",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110125684A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; 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.