Individual provider Active NPI

Nicoya Noel Pucci, CNM

  • Advanced Practice Midwife
  • Concord, CA
National Provider Identifier
1841916145
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
236317 Issued in CA
Practice address
2185 Pacheco St
Concord, CA 94520-2309
Phone
(925) 676-0300
NPI assigned
Oct 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 236317 CA Primary

Addresses

Primary practice location

2185 Pacheco St
Concord, CA 94520-2309

Mailing address

2185 Pacheco St
Concord, CA 94520-2309
Phone (925) 676-0300

Other practice location 1

1531 Esplanade
Chico, CA 95926-3310
Phone (530) 332-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230106000169 CA Practitioner - Certified Nurse Midwife (CNM) 4688044761 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Georgetown University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

500 Doyle Park Dr
Suite 200
Santa Rosa, CA 95405-4559
Phone (707) 303-1719

Hospital & facility affiliations

  • Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Enloe Medical Center CurrentSince Oct 31, 2022 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Enloe Medical Center CurrentSince Oct 31, 2022 Accepting new patients
Providence Medical Foundation CurrentSince Jun 1, 2024 Accepting new patients
Providence Medical Foundation CurrentSince Jun 1, 2024 Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients
Providence Medical Foundation Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients

Locations

1665 Esplanade
Chico, CA 95926
Phone (530) 332-5070

1423 Magnolia Ave
Chico, CA 95926
Phone (530) 332-5010

1390 E Lassen Ave
Chico, CA 95973
Phone (530) 332-6332

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

500 Doyle Park Dr
Ste 200
Santa Rosa, CA 95405
Phone (707) 303-1719

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

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 and National Provider Directory roles.

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": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1841916145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 PACHECO ST",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202309",
            "telephone_number": "925-676-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2185 PACHECO ST",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202309",
            "telephone_number": "925-676-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1531 Esplanade",
            "address_purpose": "LOCATION",
            "city": "Chico",
            "state": "CA",
            "postal_code": "959263310",
            "country_code": "US",
            "telephone_number": "530-332-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUCCI",
        "first_name": "NICOYA",
        "middle_name": "NOEL",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-18",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "236317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.