DR. ROBERT JOSEPH JR. NICOLETTA (M.D.) – Sports Medicine (Orthopaedic Surgery) Physician, NPI 1194705616

DR. ROBERT JOSEPH JR. NICOLETTA (M.D.) is a healthcare provider. based in Boston, Massachusetts. specializing in SPORTS MEDICINE, ORTHOPEDIC SURGERY. They hold the professional credentials M.D.. They hold a License No. 212596 (MA). The NPI Number for DR. ROBERT JOSEPH JR. NICOLETTA (M.D.) is 1194705616

Main info

Male
30 Years Of Experience
Accepts Medicare Assignment
Name
DR. ROBERT JOSEPH JR. NICOLETTA (M.D.)
NPI
1194705616
Phone
Not provided
Address
720 HARRISON AVE
Enumeration Date
19 January 2006
Last Update Date
21 May 2014

Doctor Profile

Medical School Name
STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Secondary Phone
6176385633
Graduation Year
1996 (30 years ago)
PAC ID
9739078288
Group Practice PAC ID
0143297655
Professional Enrollment ID
I20060928000130
Address ID
MA021182526BO725XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:20State licenses:1Digital endpointsOther names

164 SPORTS MEDICINE in MA

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Provider Addresses for DR. ROBERT JOSEPH JR. NICOLETTA (M.D.)

  • Doctors Office Building, 720, Harrison Avenue, South End, Boston, Suffolk County, Massachusetts, 02118, United States

    DOB 503

    BOSTON, MA 021182371

    Phone:

    Type: Mailing

  • Shapiro Center, 725, Albany Street, South End, Boston, Suffolk County, Massachusetts, 02118, United States

    SHAPIRO 4, SUITE B

    BOSTON, MA 021182526

    Phone: (617) 638-5633

    Fax: (617) 414-5226

    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: 2006-09-28

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
I20060928000130ISports MedicineMATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes4438$0
99215Established patient office or other outpatient visit, 40-54 minutes1414$0
View full utilization report →

Insurance plans in this area (ZIP 02118)

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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: 0143297655View full group profile
NameSpecialtyState
Physician AssistantMA
-MA
Orthopedic SurgeryMA
Physician AssistantMN
Orthopedic SurgeryMA
Orthopedic SurgeryMA
Physician AssistantMA
Physician AssistantMA
Physician AssistantMA
Orthopedic SurgeryMA

Reviews

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Frequently asked questions

What NPI should I save for DR. ROBERT JOSEPH JR. NICOLETTA (M.D.)?
Save NPI 1194705616 if you need a stable reference for DR. ROBERT JOSEPH JR. NICOLETTA (M.D.).
Is DR. ROBERT JOSEPH JR. NICOLETTA (M.D.) active in the national directory?
DR. ROBERT JOSEPH JR. NICOLETTA (M.D.)'s public NPI profile is in an active state.
What kind of provider is DR. ROBERT JOSEPH JR. NICOLETTA (M.D.)?
The page reflects Sports Medicine (Orthopaedic Surgery) Physician for DR. ROBERT JOSEPH JR. NICOLETTA (M.D.). Clinical services aligned with this taxonomy classification.
What location shows for DR. ROBERT JOSEPH JR. NICOLETTA (M.D.)?
We surface Boston, Massachusetts for DR. ROBERT JOSEPH JR. NICOLETTA (M.D.) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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