Individual provider Active NPI

Ciarra Louise Nickerson

  • Obstetrics & Gynecology Physician
  • Worcester, MA
National Provider Identifier
1740817782
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
1020071 Issued in MA
Practice address
119 Belmont St
Worcester, MA 01605-2903
Phone
(508) 334-1000
NPI assigned
Mar 26, 2020
Last updated
Aug 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Obstetrics & Gynecology Physician 207V00000X 1020071 MA Primary

Addresses

Primary practice location

119 Belmont St
Worcester, MA 01605-2903

Mailing address

328 Shrewsbury St Ste 100
Worcester, MA 01604-5465
Phone (508) 755-4861

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240814003609 MA Practitioner - Obstetrics/Gynecology 0547688608 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Massachusetts Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians for Women's Health, LLCGroup PAC ID 3274430665, 319 clinicians

Practice addresses (Care Compare)

328 Shrewsbury St
Suite 100
Worcester, MA 01604-5465
Phone (508) 755-4861

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.08 of 100Reported as group
Quality
85.82
Promoting interoperability
100
Improvement activities
40
Cost
77.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Obstetrics & Gynecology CurrentSince Apr 25, 2025 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Apr 25, 2025 Accepting new patients
Women's Health of Central Ma. PC Obstetrics & Gynecology PastSince Aug 11, 2024 Accepting new patients
Umass Memorial Medical Center, Inc. Past Accepting new patients

Locations

119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345

328 Shrewsbury St
Ste 100
Worcester, MA 01604
Phone (508) 755-4861

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: ciarra.nickerson.1@10170.direct.athenahealth.com

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

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1740817782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 SHREWSBURY ST STE 100",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016045465",
            "telephone_number": "508-755-4861",
            "fax_number": "508-752-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 BELMONT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052903",
            "telephone_number": "508-334-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "CIARRA",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2024-08-07",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "1020071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.