Individual provider Active NPI

Nicole E. Lizine, NP

  • Women's Health Nurse Practitioner
  • Norwell, MA
National Provider Identifier
1932261526
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
263361 Issued in MA
Practice address
75 Washington St
Norwell, MA 02061-1795
Phone
(781) 878-5200
Fax
(781) 871-7418
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 263361 MA Primary

Addresses

Primary practice location

75 Washington St
Norwell, MA 02061-1795

Mailing address

200 Hillcrest Rd
Marshfield, MA 02050-8254
Phone (617) 759-8739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20070205000049 MA Practitioner - Nurse Practitioner 2961404959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health Imperatives IncGroup PAC ID 9931328481, 8 clinicians

Practice addresses (Care Compare)

942 W Chestnut St
Suite 46
Brockton, MA 02301-5567
Phone (508) 583-3005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
263361MAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Imperatives Inc. CurrentSince Jan 1, 2015 Accepting new patients
Health Imperatives Inc. CurrentSince Jan 1, 2015 Accepting new patients
Health Imperatives Inc. Past Accepting new patients

Locations

942 W Chestnut St
#46
Brockton, MA 02301
Phone (508) 583-3005

942 W Chestnut St
Brockton, MA 02301
Phone (508) 583-3005

111 Torrey St
Brockton, MA 02301
Phone (508) 584-5190

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932261526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HILLCREST RD",
            "city": "MARSHFIELD",
            "state": "MA",
            "postal_code": "020508254",
            "telephone_number": "617-759-8739",
            "fax_number": "781-834-5758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 WASHINGTON ST",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611795",
            "telephone_number": "781-878-5200",
            "fax_number": "781-871-7418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZINE",
        "first_name": "NICOLE",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "263361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwell, MA

Sources for this page

Verify at the official NPI Registry.