Nicole K Smith, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA050968 Issued in PA

Practice address

40 V Twin Dr
Ste 202
Gettysburg, PA 17325-1926

Phone

(717) 339-2710

Fax

(717) 339-2711

NPI assigned

Nov 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Ms. Nicole K Denisi Brandon Other name

Medicare fee-for-service enrollment

Enrolled in PA

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gettysburg Hospital Hospital, Gettysburg, PA, CCN 390065
• Wellspan York Hospital Hospital, York, PA, CCN 390046

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nsmith16063@wellspan.direct-ci.com

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.

• Wellspan Medical Group

  • Gastroenterology Physician
  • York, PA
  • NPI 1669770004
  Medicare reassignment Care Compare group
• Wellspan Medical Group

  • Pediatric Surgery Physician
  • York, PA
  • NPI 1104799428
  NPD
• Wellspan Medical Group

  • Family Medicine Physician
  • East Berlin, PA
  • NPI 1649348525

  Physician Assistant

  NPD
• Windber Hospital, Inc.

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• The Gettysburg Hospital

  • Ambulatory Surgical Clinic/Center
  • Gettysburg, PA
  • NPI 1184882011

  Hospital

  Care Compare affiliation
• The Gettysburg Hospital

  • General Acute Care Hospital
  • Gettysburg, PA
  • NPI 1265466957
  Care Compare affiliation
• York Hospital

  • General Acute Care Hospital
  • York, PA
  • NPI 1326060492
  Care Compare affiliation
• York Hospital

  • Clinic/Center
  • York, PA
  • NPI 1497814040

  Hospital

  Care Compare affiliation
• York Hospital

  • Clinic/Center
  • York, PA
  • NPI 1609112036

  Hospital

  Care Compare affiliation
• York Hospital

  • Family Medicine Physician
  • York, PA
  • NPI 1881617132

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1003986878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-339-2710",
            "fax_number": "717-339-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 V TWIN DR",
            "address_2": "STE 202",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "173251926",
            "telephone_number": "717-339-2710",
            "fax_number": "717-339-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICOLE",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA050968",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA050968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY MEDICARE ASSURED",
            "identifier": "1602843",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD - FREEDOM BLUE",
            "identifier": "2566850",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF STATE BUREAU OF P",
            "identifier": "MA05096A",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00549500",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "DENISI BRANDON",
            "middle_name": "K",
            "prefix": "MS.",
            "credential": "MPASC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dominic Smith, M.D.
• Donna L Smith, CAC
• Jerrod M Smith, BS
• Joanne E Smith, CRNP
• Julie A Smith, RRA, RPA
• Smitha Nair MD PC
• Valerie Denise Snare, OTR/L
• Kevin Christopher Snow, MS
• Anna Nicole Snyder
• Lyndsay L Snyder, PA-C

• Medical Physician Assistant in Gettysburg, PA
• Providers in Gettysburg, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.