NPIMap

Individual provider Active NPI

Nicolas Antico, PA-C

  • Physician Assistant
  • Meriden, CT
National Provider Identifier
1801352133
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
90 Cynrose PL
Meriden, CT 06451-2772
Phone
(203) 317-1208
NPI assigned
Feb 12, 2019
Last updated
Feb 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CT Primary

Addresses

Primary practice location

90 Cynrose PL
Meriden, CT 06451-2772

Mailing address

90 Cynrose PL
Meriden, CT 06451-2772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20190402002314 CT Practitioner - Physician Assistant 4981945896 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bridgeport HospitalGroup PAC ID 2062312598, 134 clinicians
Midstate Medical CenterGroup PAC ID 7416840699, 187 clinicians

Practice addresses (Care Compare)

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3000

435 Lewis Ave
Meriden, CT 06451-2101
Phone (203) 694-8200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.02 of 100Reported as group
Quality
87.5
Promoting interoperability
100
Improvement activities
40
Cost
77.51

Merit-based Incentive Payment System (MIPS)

Final score
97.06 of 100Reported as group
Quality
87.5
Promoting interoperability
100
Improvement activities
40
Cost
77.51

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence and Memorial Hospital, Inc. Physician Assistant CurrentSince Apr 1, 2019 Accepting new patients
Hartford Healthcare Urgent Care Centers, LLC CurrentSince Nov 1, 2025 Accepting new patients
Lawrence and Memorial Hospital, Inc. CurrentSince Apr 1, 2019 Accepting new patients
Midstate Medical Center CurrentSince Mar 1, 2022 Accepting new patients
Afc Physicians of Connecticut, PC CurrentSince Aug 1, 2019 Accepting new patients
Bridgeport Hospital CurrentSince Jan 29, 2024 Accepting new patients

Locations

385 W Main St
Avon, CT 06001
Phone (860) 777-1280

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

2 Main St
Danbury, CT 06810
Phone (203) 826-2140

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

Interoperability endpoints

  • Direct secure messaging: nicholas.antico@xdr.hhchealthdirect.org

Organizations & group practices 9

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 2

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": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1801352133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 CYNROSE PL",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 CYNROSE PL",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512772",
            "telephone_number": "203-317-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTICO",
        "first_name": "NICOLAS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

Verify at the official NPI Registry.