Nicole Cimino-Nardolillo, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

7131506 Issued in NY

Practice address

125 Oakland Ave
Suite 204
Port Jefferson, NY 11777-2130

Phone

(631) 686-2524

Fax

(631) 686-2526

NPI assigned

Oct 26, 2011

Last updated

Jun 6, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Harbor View Medical Services PCGroup PAC ID 5092865873, 58 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: nicole.cimino.1@8551.direct.athenahealth.com

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.

• Harbor View Medical Services PC

  dba Mather Medical Group

  • Internal Medicine Physician
  • Port Jefferson, NY
  • NPI 1306631742
  Medicare reassignment Care Compare group
• Vikas Desai MD PC

  • Internal Medicine Physician
  • East Islip, NY
  • NPI 1407096282
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• John T. Mather Memorial Hospital

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1093718728
  Care Compare affiliation

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1891071544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 OAKLAND AVE",
            "address_2": "SUITE 204",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772130",
            "telephone_number": "631-686-2524",
            "fax_number": "631-686-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 OAKLAND AVE",
            "address_2": "SUITE 204",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772130",
            "telephone_number": "631-686-2524",
            "fax_number": "631-686-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIMINO-NARDOLILLO",
        "first_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-26",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "7131506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Beatty, MD, PC
• Paula C. Chropufka, D.P.T.
• John C Chumas, M.D.
• Zachary Chung
• Halyna Chykyda
• Rachel Cipriano, RD
• Marilyn Hurley Cleary, MA,OTRL
• Nicholas Clemente, DO
• Leonard Patrick Close III, DDS
• Rheanna Louise Cluckey

• Medical Physician Assistant in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; 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.