Nicolas Antico, PA-C
Individual provider Active NPI Physician Assistant · Meriden, CT
NPI 1801352133 · NPPES record last updated Feb 12, 2019
Key facts
- NPI
- 1801352133
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 90 Cynrose PL
Meriden, CT 06451-2772 - Phone
- (203) 317-1208
- NPI assigned
- Feb 12, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 12
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bridgeport Hospital
Midstate Medical Center
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
- Midstate Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.02 of 100
- Quality
- 87.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.51
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.06 of 100
- Quality
- 87.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.51
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190402002314 | CT | Practitioner - Physician Assistant | 4981945896 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4403 | CT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lawrence and Memorial Hospital, Inc. | Physician Assistant | Current |
Accepting new patients |
| Lawrence and Memorial Hospital, Inc. | Current |
Accepting new patients | |
| Afc Physicians of Connecticut, PC | Current |
Accepting new patients | |
| Midstate Medical Center | Current |
Accepting new patients | |
| Afc Physicians of Connecticut, PC | Current |
Accepting new patients | |
| Hartford Healthcare Urgent Care Centers, LLC | Current |
Accepting new patients |
Locations
385 W Main St
Avon, CT 06001
Phone (860) 777-1280
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
- nicholas.antico@xdr.hhchealthdirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | CT | Yes |
Addresses
Primary practice location
90 Cynrose PL
Meriden, CT 06451-2772
Mailing address
90 Cynrose PL
Meriden, CT 06451-2772
Other providers in Meriden, CT
- Anjali Banerjee DMD PLLC
- Lauren Annino
- Elizabeth R Antal
- Debra J Antari
- Anthony G Lendino M.D. LLC
- Divya Reddy Anugu
- Apple Dental and Associates,LLC
- Appointed to Care LLC
- Karen Armstrong
- Breonna Arnum
All providers in Meriden, CT · Physician Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.