NICOLE ROSE CICCIA – Surgical Physician Assistant, NPI 1912413139

NICOLE ROSE CICCIA is a healthcare provider. based in Milford, Connecticut. specializing in PHYSICIAN ASSISTANT. They hold a License No. 4036 (CT). The NPI Number for NICOLE ROSE CICCIA is 1912413139

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE ROSE CICCIA
NPI
1912413139
Phone
Not provided
Address
71 JOY RD APT C
Enumeration Date
26 December 2017
Last Update Date
23 November 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
20386754204405
Graduation Year
2017 (9 years ago)
PAC ID
0446513626
Group Practice PAC ID
9436061736
Professional Enrollment ID
I20180423001137

Contacts

Secure Messaging
nciccia338424@direct.stfranciscare.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness85
Years active:8State licenses:1Other namesUpdated within 12 months

3,243 PHYSICIAN ASSISTANT in CT

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Provider Addresses for NICOLE ROSE CICCIA

  • 71 JOY RD APT C

    MILFORD, CT 064606052

    Phone:

    Type: Mailing

  • Yale New Haven Hospital, 20, York Street, Downtown, New Haven, New Haven County, Connecticut, 06510, United States

    NEW HAVEN, CT 065103220

    Phone: (203) 688-4242

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-04-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180423001137IPhysician AssistantCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06460)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9436061736View full group profile
NameSpecialtyState
Interventional Cardiology, Cardiovascular Disease (Cardiology)CT
H E M A T O L O G Y/ O N C O L O G YCT
Internal Medicine, NephrologySC
-CT
-NC
Internal MedicineCT
-CT
Cardiac SurgeryCT
-CT
-CT

Reviews

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Frequently asked questions

How is NICOLE ROSE CICCIA identified in CMS data?
CMS-hosted NPPES data lists NICOLE ROSE CICCIA with NPI 1912413139.
Is NICOLE ROSE CICCIA listed as active for patients and plans?
The listing shows NICOLE ROSE CICCIA as active in the NPI system.
What is NICOLE ROSE CICCIA best known for clinically?
Directory data describes NICOLE ROSE CICCIA with Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
Where should I expect NICOLE ROSE CICCIA on a map?
Expect Milford, Connecticut as a primary anchor for NICOLE ROSE CICCIA unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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