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PEYTON NICKERSON
NPI 1023834660
Student in an Organized Health Care Education/Training Program in Boston, MA

Active since November 27, 2024PECOS Enrolled
136 HARRISON AVE, BOSTON, MA 02111(207) 408-0825 Get Directions Write a Review

NPPES record last updated: November 27, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Peyton Nickerson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEYTON NICKERSON (NPI 1023834660) is an individual student in an organized health care education/training program in Boston, Massachusetts and active in the NPI registry since November 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2026).

NPPES Registry Identity

NPI1023834660
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NamePEYTON NICKERSON
Location Address136 HARRISON AVEBoston, MA 02111-1817
Mailing Address136 Harrison AveBoston, MA 02111-1817 · (207) 408-0825
Phone(207) 408-0825
Sole ProprietorYes
Medical School CMSOtherGraduated 2026
Enumeration DateNovember 27, 2024
NPPES CertifiedNovember 27, 2024
✔ NPI 1023834660 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

136 HARRISON AVE, Boston, MA 02111
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Peyton Nickerson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3870078181
PECOS Enrollment IDI20260403000559
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOYCE A SACKEY M.D.
Internal Medicine
136 HARRISON AVE, SACKLER 8TH FLOOR
BOSTON, MA 02111
Suffolk County (617) 636-6565
DR. MARC MICHAEL EDELSTEIN M.D.
Pediatrics
136 HARRISON AVE
BOSTON, MA 02111
Suffolk County (617) 636-1000
PAUL ANDREW HATTIS M.D.
Preventive Medicine (Public Health & General Preventive Medicine)
136 HARRISON AVE
BOSTON, MA 02111
Suffolk County (617) 636-2498
DR. JACQUELINE JOELLE FREMONT-RAHL DVM, MS
Veterinarian
136 HARRISON AVE
BOSTON, MA 02111
Suffolk County (617) 636-5615
TUFTS UNIVERSITY SCHOOL OF MEDICINE
General Acute Care Hospital
136 HARRISON AVE
BOSTON, MA 02111
Suffolk County (617) 970-5725
KELLY KATHLEEN BARRY MS
Student in an Organized Health Care Education/Training Program
136 HARRISON AVE
BOSTON, MA 02111
Suffolk County (630) 670-0921
MOLLIE MIKULSKI
Student in an Organized Health Care Education/Training Program
136 HARRISON AVE
BOSTON, MA 02111
Suffolk County (617) 636-7000
TYLER STRAUSS
Student in an Organized Health Care Education/Training Program
136 HARRISON AVE
BOSTON, MA 02111
Suffolk County (617) 636-7000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Peyton Nickerson's NPI number?

The NPI number for Peyton Nickerson is 1023834660. It was assigned to this individual provider in the NPPES registry on November 27, 2024.

Where is Peyton Nickerson located?

Peyton Nickerson practices at 136 Harrison Ave, Boston, MA 02111. The listed phone number is (207) 408-0825.

What is Peyton Nickerson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Peyton Nickerson enrolled in Medicare?

Yes. Peyton Nickerson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Peyton Nickerson was last updated on November 27, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.