Nichole A Hubbard, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

50001377 Issued in OH

Practice address

2751 Bay Park Dr Ste 303
Oregon, OH 43616-4922

Phone

(419) 693-0711

Fax

(419) 693-2320

NPI assigned

Jul 5, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nichole Ann Bergman Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259
• Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nhubbard7866@direct.promedica.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Promedica Central Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1043270150
  Medicare reassignment Care Compare group NPD
• Promedica Children's Specialists

  • Pediatrics Physician
  • Toledo, OH
  • NPI 1245444959
  Medicare reassignment
• The Toledo Hospital

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1407854771
  Medicare reassignment
• Consultants in Laboratory Medicine of Greater Toledo

  • Anatomic Pathology & Clinical Pathology Physician
  • Toledo, OH
  • NPI 1982673372
  NPD
• Promedica Central Physicians

  dba ProMedica Physicians Durable Medical Equipment

  • Durable Medical Equipment & Medical Supplies
  • Toledo, OH
  • NPI 1669068482
  NPD
• The Toledo Hospital

  dba ProMedica Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Toledo, OH
  • NPI 1740217678
  NPD
• The Toledo Hospital

  dba ProMedica Toledo Hospital Emergency and Urgent Care

  • Urgent Care Clinic/Center
  • Maumee, OH
  • NPI 1831863943
  NPD
• Haematology-Oncology Associates of Ohio and Michigan PC

  • Hematology & Oncology Physician
  • Lambertville, MI
  • NPI 1841296605
  NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Observation Physicians of Northwest Ohio LLC

  • Emergency Medicine Physician
  • Toledo, OH
  • NPI 1700462967
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bay Park Community Hospital

  • General Acute Care Hospital
  • Oregon, OH
  • NPI 1598765539
  Care Compare affiliation
• The Toledo Hospital

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1407854771
  Care Compare affiliation
• Toledo Hospital

  dba ProMedica Transportation Network

  • Ambulance
  • Toledo, OH
  • NPI 1427147339

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1003813197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 BAY PARK DR STE 303",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436164922",
            "telephone_number": "419-693-0711",
            "fax_number": "419-693-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "NICHOLE",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50001377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0067932",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nhubbard7866@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "BERGMAN",
            "middle_name": "ANN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Tyler David Hoyles, PHARMD, RPH
• Jeff Hugus, MD
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• Ingrid a. Alcover, MD, Inc
• Corinne A Iova, CRNA

• Medical Physician Assistant in Oregon, OH
• Providers in Oregon, OH by specialty
• Medical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.