NPIMap

Individual provider Active NPI

Nicole Teresa Wasylyk, PA-C

  • Physician Assistant
  • Lebanon, NH
National Provider Identifier
1699174946
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1848 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone
(603) 650-5133
NPI assigned
Aug 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0663 NH
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 1848 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
Lebanon, NH 03756-1000
Phone (603) 650-5133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220425001716 NH Practitioner - Physician Assistant 5294122149 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

Hospital & facility affiliations

  • Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003
  • New London Hospital Hospital, New London, NH, CCN 301304
  • Springfield Hospital Hospital, Springfield, VT, CCN 471306
  • Mt Ascutney Hospital Hospital, Windsor, VT, CCN 471302
  • North Country Hospital and Health Center Hospital, Newport, VT, CCN 471304

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0663NHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alice Peck Day Memorial Hospital CurrentSince Jan 19, 2026 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Apr 13, 2022 Accepting new patients
Alice Peck Day Memorial Hospital Current Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Apr 13, 2022 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Apr 13, 2022 Accepting new patients
Alice Peck Day Memorial Hospital CurrentSince Jan 19, 2026 Accepting new patients
Mary Hitchcock Memorial Hospital Past Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

10 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-7440

5 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-3996

273 County Rd
New London, NH 03257
Phone (603) 526-5215

Interoperability endpoints

  • Direct secure messaging: nwasylyk202034@direct.dartmouth-hitchcock.org
  • FHIR API: https://edhwebportal.hitchcock.org/FHIRProxy/api/FHIR/R4/

Organizations & group practices 7

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1699174946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-5133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-5133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASYLYK",
        "first_name": "NICOLE",
        "middle_name": "TERESA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NH",
            "license": "0663",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.