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NICOLE CATHERINE POLILLIO NP
NPI 1033004189
Nurse Practitioner - Family in Providence, RI

Active since June 10, 2025PECOS Enrolled
101 DUDLEY ST, PROVIDENCE, RI 02905(401) 274-1100 Get Directions Write a Review

NPPES record last updated: September 3, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 3, 2025, Jun 10, 2025 (2 updates tracked since 2025).

About Nicole Catherine Polillio Np NPPES

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

NICOLE CATHERINE POLILLIO NP (NPI 1033004189) is an individual family provider in Providence, Rhode Island, licensed in Rhode Island (APRN04767) and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1033004189
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameNICOLE CATHERINE POLILLIOCredential: NP
Location Address101 DUDLEY STProvidence, RI 02905-2401
Mailing Address455 Toll Gate Rd, Prc And CredentialingWarwick, RI 02886-2759 · (401) 273-0641 · Fax (401) 273-2919
Phone(401) 274-1100
Sole ProprietorNo
Enumeration DateJune 10, 2025
Last NPPES UpdateSeptember 3, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 3, 2025
✔ NPI 1033004189 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in RI · APRN04767✔ Licensed in MA · F05250649
101 DUDLEY ST, Providence, RI 02905
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Catherine Polillio Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Nicole Polillio reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Affinity Physicians LLC
Same address
Anesthesiology
101 DUDLEY STREET, WIH DEPT OF ANESTHESIOLOGY
Providence, RI 02905
  • Reassigned Medicare billing, Rhode Island enrollment
  • 984 clinicians in this Medicare group
NPI 1053038471 (401) 274-1122

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02905 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.48 typical visit price
range $58.57 – $177.03
Typical copayment $22.62 (range $14.64 – $44.25)
Most-billed visit code 99203
Established Patient
$103.10 typical visit price
range $18.92 – $144.38
Typical copayment $25.77 (range $4.73 – $36.09)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

CHRISTOPHER DONALD PALMER DO
Internal Medicine
101 DUDLEY ST
PROVIDENCE, RI 02905
Providence County (401) 274-1122
BRITTANY S HAMPTON MD
Obstetrics & Gynecology (Urogynecology and Reconstructive Pelvic Surgery)
101 DUDLEY ST
PROVIDENCE, RI 02905
Providence County (401) 274-1100
HEIDI FANION LCSW
Social Worker (Clinical)
101 DUDLEY ST
PROVIDENCE, RI 02905
Providence County (401) 274-1100
MS. LINDA BEETLESTONE MS
Genetic Counselor, MS
101 DUDLEY ST
PROVIDENCE, RI 02905
Providence County (401) 453-7515
JULIE ANNA KNUTSON RN, CNM
Advanced Practice Midwife
101 DUDLEY ST
PROVIDENCE, RI 02905
Providence County (401) 274-1122
BETHANY DAWSON LICSW
Social Worker (Clinical)
101 DUDLEY ST
PROVIDENCE, RI 02905
Providence County (401) 274-1100
HEATHER A SMITH MD, MPH
Obstetrics & Gynecology (Obstetrics)
101 DUDLEY ST
PROVIDENCE, RI 02905
Providence County (401) 274-1122
NADINE C KASSIS MD
Obstetrics & Gynecology
101 DUDLEY ST
PROVIDENCE, RI 02905
Providence County (401) 274-1100

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 Nicole Polillio's NPI number?

The NPI number for Nicole Polillio is 1033004189. It was assigned to this individual provider in the NPPES registry on June 10, 2025.

Where is Nicole Polillio located?

Nicole Polillio practices at 101 Dudley St, Providence, RI 02905. The listed phone number is (401) 274-1100.

What is Nicole Polillio's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Nicole Polillio enrolled in Medicare?

Yes. Nicole Polillio is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Nicole Polillio's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Polillio reassigns Medicare benefits to Affinity Physicians LLC (Providence, RI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicole Polillio's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nicole Polillio was last updated on September 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.