Individual provider Active NPI

Nicole Maria Lanzo, NP

  • Family Medicine Physician
  • Tewksbury, MA
National Provider Identifier
1699476648
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
RN2344342 Issued in MA
Practice address
2345 Main St
Tewksbury, MA 01876-3125
Phone
(978) 658-9931
NPI assigned
Mar 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RN2344342 MA Primary

Addresses

Primary practice location

2345 Main St
Tewksbury, MA 01876-3125

Mailing address

5 Putnam St
Watertown, MA 02472-4243
Phone (617) 458-2935

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
I20240712001268 MA Practitioner - Nurse Practitioner 5092250142 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beth Israel Lahey Health Primary Care, IncGroup PAC ID 7719291434, 351 clinicians

Practice addresses (Care Compare)

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

Hospital & facility affiliations

  • Winchester Hospital Hospital, Winchester, MA, CCN 220105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Dec 1, 2024 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Winchester Physician Associates, Inc Family Medicine CurrentSince Jul 22, 2024 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. Past Accepting new patients
Winchester Physician Associates Past Accepting new patients

Locations

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

203 Main St
North Reading, MA 01864
Phone (978) 664-1990

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

88 Montvale Ave
Stoneham, MA 02180
Phone (781) 481-9255

2345 Main St
Tewksbury, MA 01876
Phone (978) 658-9931

Interoperability endpoints

  • FHIR API: https://fhir.laheyhealth.org/proxy-prd-fhir/api/FHIR/R4/
  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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 1

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": "1678924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1699476648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PUTNAM ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724243",
            "telephone_number": "617-458-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 MAIN ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018763125",
            "telephone_number": "978-658-9931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANZO",
        "first_name": "NICOLE",
        "middle_name": "MARIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-16",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "RN2344342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tewksbury, MA

Sources for this page

Verify at the official NPI Registry.