LYDIA L MUSULA (PA-C) – Physician Assistant, NPI 1396141610

LYDIA L MUSULA (PA-C) is a healthcare provider. based in Revere, Massachusetts. specializing in Physician Assistant. They hold the professional credentials PA-C. They hold a License No. PA00767 (RI). The NPI Number for LYDIA L MUSULA (PA-C) is 1396141610

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
LYDIA L MUSULA (PA-C)
NPI
1396141610
Phone
(781) 485-8222
Address
454 BROADWAY
Enumeration Date
13 November 2014
Last Update Date
19 August 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4017377010
Graduation Year
2014 (12 years ago)
PAC ID
2163749565
Group Practice PAC ID
0244413391
Professional Enrollment ID
I20170117001046
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:11State licenses:1Digital endpointsOther names

Provider Addresses for LYDIA L MUSULA (PA-C)

  • 454 BROADWAY

    REVERE, MA 021513034

    Phone: (781) 485-8222

    Fax: (781) 485-8220

    Type: Mailing

  • 454 Broadway

    Revere, MA 021513034

    Phone: (781) 485-8222

    Fax: (781) 485-8220

    Type: Location

  • 593 EDDY ST

    PROVIDENCE, RI 029034923

    Phone: (401) 444-6195

    Type: Location

  • 117 ELLENFIELD ST STE 101

    PROVIDENCE, RI 029054541

    Phone: (401) 444-6779

    Fax: (401) 444-6912

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $18.

Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.

Last reported payment date: 2023-05-25 • Largest payer in this snapshot: Novo Nordisk Inc ($18).

Total Amount

$18

General + Research + Ownership

Payments

1

Total payment records

General Amount

$18

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-05-25

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Novo Nordisk Inc$18
View all Open Payments →|Open Payments Risk Radar →

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: 2017-01-17

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
I20170117001046IPhysician AssistantRITBD

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 02151)

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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: 0244413391View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YRI
Internal MedicineRI
Physician AssistantRI
A N E S T H E S I O L O G YRI
A N E S T H E S I O L O G YRI
Cardiovascular Disease (Cardiology), Interventional Cardiology, Interventional Cardiology, Cardiovascular Disease (Cardiology)RI
Cardiovascular Disease (Cardiology)MA
Internal Medicine, Pulmonary Disease, Pulmonary DiseaseMA
O B S T E T R I C S/ G Y N E C O L O G YNY
-RI

Reviews

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Frequently asked questions

Does LYDIA L MUSULA (PA-C) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — LYDIA L MUSULA (PA-C) uses 1396141610.
Does CMS list LYDIA L MUSULA (PA-C) as active?
Yes — LYDIA L MUSULA (PA-C) is active in the NPI listing used on this page.
What healthcare role does LYDIA L MUSULA (PA-C) hold?
Scheduling teams often label LYDIA L MUSULA (PA-C) under Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is LYDIA L MUSULA (PA-C) based?
LYDIA L MUSULA (PA-C) is tied to Revere, Massachusetts in the data we show; additional addresses may exist on the full record.
Why does LYDIA L MUSULA (PA-C) have multiple addresses?
5 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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