Nicolette C Walsh, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD041295L Issued in PA

Practice address

4247 W Ridge Rd Ste 105
Erie, PA 16506

Phone

(814) 838-2468

Fax

(814) 835-2599

NPI assigned

Jul 10, 2006

Last updated

Oct 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Merit-based Incentive Payment System (MIPS)

Final score

93.9 of 100Reported as apm

Quality

85.02

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nwalsh206121@direct.ahn.org

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.

• St Vincent Medical Education and Research Institute Inc

  • Internal Medicine Physician
  • Erie, PA
  • NPI 1902881477

  Family Medicine

  Medicare reassignment NPD
• Fred K Fioravanti, MD

  • Family Medicine Physician
  • Cabot, PA
  • NPI 1285620906
  Medicare reassignment
• Concordia Physician Practice

  • Family Medicine Physician
  • Cabot, PA
  • NPI 1699153247
  NPD
• Fred K. Fioravanti

  • Specialist
  • Saxonburg, PA
  • NPI 1437273851
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1760416275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4247 W RIDGE RD STE 105",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165061746",
            "telephone_number": "814-838-2468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4247 W RIDGE RD STE 105",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "16506",
            "telephone_number": "814-838-2468",
            "fax_number": "814-835-2599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Marwood Rd",
            "address_2": "#5000",
            "address_purpose": "LOCATION",
            "city": "Cabot",
            "state": "PA",
            "postal_code": "160232239",
            "country_code": "US",
            "telephone_number": "724-352-4448",
            "fax_number": "724-352-4412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "NICOLETTE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD041295L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nwalsh206121@direct.ahn.org",
            "affiliation": "N",
            "address_1": "4247 W Ridge Rd Ste 105",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "16506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristen Wallace
• Ryan Jeffrey Wallace, PA-C
• Walnut Creek PA Opco LLC (Walnut Creek Nursing and Rehab)
• Alissa Jeanne Walsh, LPC, CAADC, ATR-BC
• Emily Walsh, OD
• Gregory James Walters, M.A., NCC, LPC
• Matthew Alexander Walukonis, MD
• Xinshi Wang
• Barbara Waples
• Jan Warburton, PHD

• Family Medicine Physician in Erie, PA
• Providers in Erie, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.

Verify at the official NPI Registry.