Martin Haynes Nicol Sr., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

003345-1 Issued in NY

Practice address

2367-69 2ND Ave
New York, NY 10035-3108

Phone

(212) 876-2300

Fax

(212) 369-8209

NPI assigned

May 25, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mnicol1268696@nychhc.direct-ci.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1003027459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 REMSEN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112121342",
            "telephone_number": "718-467-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2367-69 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353108",
            "telephone_number": "212-876-2300",
            "fax_number": "212-369-8209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOL",
        "first_name": "MARTIN",
        "middle_name": "HAYNES",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "003345-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Nicklay, M.A.T.
• Kali Nickles
• Leroy Nickles, M.D.
• Katy Anne Nickolaus, PA-C
• Cecilia E.W. Nicol, MD
• Alice Helena Nicola
• Mona Nicolae, M.D.
• Viorel Nicolaescu, M.D
• Charles V Nicolai, D.C.
• Kristen Nicolai, MS, RD, CDN

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.