MS. KELLY M. CICCONE (NPI# 1710054713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710054713 |
| Entity Type | Individual |
| Full Name | MS. KELLY M. CICCONE |
| Other Name | KELLY M. WILLIAMS |
| Credential | PA-C |
| Practice Address |
Lahey Clinic 41 Mall Rd Burlington MA 01805-0001 |
| Practice Telephone | 7817448886 |
| Practice Fax Number | 7817442956 |
| Mailing Telephone | 7817448886 |
| Mailing Fax Number | 7817442956 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2013-10-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 2035 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
LAHEY CLINIC 41 MALL RD |
| City | BURLINGTON |
| State | MA |
| Zip Code | 01805-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275569972 | Christopher T. Pyne | Internal Medicine | Lahey Clinic 41 Mall Rd, Burlington, MA 01805-0001 | 2006-06-24 |
| 1386164226 | Shakti Aishwarya Nochur | Student in an Organized Health Care Education/Training Program | Lahey Clinic 41 Mall Rd, Burlington, MA 01805-0001 | 2017-06-21 |
| 1841384195 | John F. Bresette | Urology | Lahey Clinic 41 Mall Rd, Burlington, MA 01805-0001 | 2006-10-03 |
| 1851483168 | Mary Ann Tremble | Nurse Practitioner | Lahey Clinic 41 Mall Rd, Burlington, MA 01805-0001 | 2006-09-28 |
| 1184715179 | Julie Elizabeth Crowley | Internal Medicine | Lahey Clinic 41 Mall Rd, Burlington, MA 01805-0001 | 2006-09-27 |
| 1497793277 | Khalid Khwaja | Transplant Surgery | Lahey Clinic 41 Mall Rd, 4 West, Burlington, MA 01805-0001 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750867909 | Natalie Teresa Dal'bo | Student in an Organized Health Care Education/Training Program | 41 Mall Road Office of Graduate Medical Education, Burlington, MA 01805 | 2018-07-11 |
| 1043710791 | Beth Israel Lahey Health Primary Care, Inc. | Urology | Lahey Institute of Urology, Beverly, 41 Mall Rd., Burlington, MA 01805 | 2018-02-20 |
| 1902240872 | Lloyd Jones Jr. | Student in an Organized Health Care Education/Training Program | 41 Mall Rd Department of Plastic Surgery, Burlington, MA 01805 | 2013-04-23 |
| 1508020470 | Russell Andrew Baur | Internal Medicine | Lahey Clinic Inc., 41 Mall Road, Burlington, MA 01805 | 2008-07-10 |
| 1356491237 | Jacob Magee Sands | Internal Medicine | 41 Burlington Mall Rd., Lahey Clinic, Burlington, MA 01805 | 2007-01-11 |
| 1588757108 | Richard Alan Wold | Nurse Anesthetist, Certified Registered | Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA 01805 | 2006-10-02 |
| 1841302387 | David M. Venesy | Internal Medicine | Lahey Clinic Cardiology -5 E, 41 Mall Road, Burlington, MA 01805 | 2006-08-31 |
| 1790750354 | Cara J. Foss | Nurse Practitioner | Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA 01805 | 2006-02-17 |
| 1750376380 | Darryl D Esakof | Internal Medicine | 41 Mall Road, Department of Cardiovascular Medicine, Lahey Clinic, Burlington, MA 01805 | 2005-09-20 |
| 1225022155 | Laura Saluja | Internal Medicine | Lahey Clinic - General Internal Medicine, 41 Mall Road, Burlington, MA 01805 | 2005-09-07 |
| Find all providers in zip 01805 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598399743 | Samantha Pandick Vaillancourt | Physician Assistant | 1236 Huffman Mill Rd Ste 100, Burlington, NC 27215-8700 | 2020-02-26 |
| 1770116576 | Mh Medical Services, PC | Physician Assistant | 1737 Whites Kennel Rd, Burlington, NC 27215-8977 | 2020-02-20 |
| 1578113908 | Avani Shah | Physician Assistant | 41 Burlington Mall Road 7 West Neurology Dept, Burlington, MA 01805-2015 | 2019-09-17 |
| 1174087548 | Lindsay Elaine Damaso | Physician Assistant | 6 Frothingham Rd, Burlington, MA 01803-4002 | 2019-01-30 |
| 1902375744 | San Michael Kyte | Physician Assistant | 104 Huffman Mill Rd Ste 100, Burlington, NC 27215-5113 | 2018-11-22 |
| 1871010074 | Adriana M Pollak | Physician Assistant | 1041 Kirkpatrick Rd Ste 200, Burlington, NC 27215-8066 | 2017-08-28 |
| 1679920581 | Jenna Bruno | Physician Assistant | 8 Pontos Ave, Burlington, MA 01803-2127 | 2016-05-20 |
| 1770963332 | Christopher Walden | Physician Assistant | 2016 Wall Ave, Burlington, NJ 08016-3616 | 2015-06-08 |
| 1447655568 | Bushra Khan | Physician Assistant | 1174 Kaye Ct, Burlington, NJ 08016-2266 | 2014-10-31 |
| 1831527191 | Autumn Kari Konz | Physician Assistant | 1234 Huffman Hill Road, Burlington, NC 27215-8700 | 2013-10-24 |
| Find all providers in BURLINGTON | ||||
| City | BURLINGTON |
| Zip Code | 01805 |
Please comment or provide details below to improve the information on MS. KELLY M. CICCONE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.