NPIMap

Individual provider Active NPI

Nicholas J Rencricca, M.D.

  • Internal Medicine Physician
  • Dartmouth, MA
National Provider Identifier
1710945548
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
77221 Issued in MA
Practice address
400 Faunce Corner Rd
Medical Department
Dartmouth, MA 02747-1275
Phone
(508) 995-6400
NPI assigned
May 2, 2006
Last updated
Apr 23, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 77221 MA Primary

Addresses

Primary practice location

400 Faunce Corner Rd
Medical Department
Dartmouth, MA 02747-1275

Mailing address

400 Faunce Corner Rd
Medical Department
Dartmouth, MA 02747-1275
Phone (508) 995-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050817000643 MA Practitioner - Internal Medicine 7315977519 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
77221MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brockton Hospital, Inc. Past Accepting new patients
Brockton Hospital, Inc. Past Accepting new patients
Signature Healthcare Medical Group Inc Internal Medicine PastSince Oct 1, 2009 Accepting new patients
The Commonwealth of Massachusetts Past Accepting new patients
Brighton Family Practice, Inc Internal Medicine Past Accepting new patients
Preventive Medicine Associates Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1710945548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FAUNCE CORNER RD",
            "address_2": "MEDICAL DEPARTMENT",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027471275",
            "telephone_number": "508-995-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 FAUNCE CORNER RD",
            "address_2": "MEDICAL DEPARTMENT",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027471275",
            "telephone_number": "508-995-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENCRICCA",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "77221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dartmouth, MA

Sources for this page

Verify at the official NPI Registry.