Nicole Mazyck, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA102340 Issued in MA

Practice address

70 Francis St
Boston, MA 02115-6134

Phone

(617) 732-5500

NPI assigned

May 30, 2024

Last updated

Aug 16, 2026By 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 3

Addresses

Other names 1

• Nicole Van Etten Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vanderbilt University Medical CenterGroup PAC ID 5092023416, 3,510 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vanderbilt University Medical Center Hospital, Nashville, TN, CCN 440039

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nvanetten882562@direct.vumc.org

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.

• Vanderbilt University Medical Center

  dba Vanderbilt Medical Group

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1104202761
  Medicare reassignment Care Compare group NPD
• Vanderbilt University

  dba Vanderbilt Medical Group

  • Clinical Social Worker
  • Nashville, TN
  • NPI 1285659706
  NPD (past)

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

• Vanderbilt University Medical Center

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1396882205
  Care Compare affiliation

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786838400000",
    "number": "1952141426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156134",
            "telephone_number": "617-732-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156134",
            "telephone_number": "617-732-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZYCK",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-30",
        "last_updated": "2026-08-16",
        "certification_date": "2026-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA102340",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5997",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nvanetten882562@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "3601 The Vanderbilt Clinic",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372320014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "VAN ETTEN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Varvara Mazina, MD
• Liza Berkowitz Mazo, LICSW
• Maitreyi Mazumdar, MD
• Soumyaa Mazumder, MD
• Lynn Ann Mazur, LICSW
• Brittney Jaye Mazza, O.D.
• Sara Mazzantini, MD
• Marcella Mazzenga, LCSW
• Zachery R Mazzie-Smith, PA-C
• Michael J Mazzini, M.D.

• Physician Assistant in Boston, MA
• Providers in Boston, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2026; 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.