Individual provider Active NPI

Nicole Elizabeth Tyczynska, M.D.

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1992061865
Registry record updated Mar 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD454955 Issued in PA
Practice address
1020 Sansom St
Suite 239
Philadelphia, PA 19107-5002
Phone
(215) 955-6844
Fax
(215) 955-2526
NPI assigned
Apr 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD454955 PA Primary

Addresses

Primary practice location

1020 Sansom St
Suite 239
Philadelphia, PA 19107-5002

Mailing address

1020 Sansom St
Suite 239
Philadelphia, PA 19107-5002
Phone (215) 955-6844

Other names 1

  • Dr. Nicole Elizabeth Piela Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150717000253 PA Practitioner - Emergency Medicine 3173756285 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 662-8214

Hospital & facility affiliations

  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226
  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD454955PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Apr 8, 2024 Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Jul 1, 2015 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Jul 1, 2015 Accepting new patients
University of Penn-Medical Group CurrentSince Apr 8, 2024 Accepting new patients

Locations

700 Walnut St
Philadelphia, PA 19106
Phone (215) 503-7300

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

Organizations & group practices 5

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 2

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": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1992061865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 SANSOM ST",
            "address_2": "SUITE 239",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075002",
            "telephone_number": "215-955-6844",
            "fax_number": "215-955-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 SANSOM ST",
            "address_2": "SUITE 239",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075002",
            "telephone_number": "215-955-6844",
            "fax_number": "215-955-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYCZYNSKA",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-05",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD454955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "PIELA",
            "middle_name": "ELIZABETH",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.