Individual provider Active NPI

Michel V Nicol, PA-C

  • Physician Assistant
  • Beaver, PA
National Provider Identifier
1063996361
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA060164 Issued in PA
Practice address
1000 Dutch Ridge Rd
Beaver, PA 15009-9727
Phone
(877) 771-4847
NPI assigned
Sep 21, 2018
Last updated
Jul 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA060164 PA Primary

Addresses

Primary practice location

1000 Dutch Ridge Rd
Beaver, PA 15009-9727

Mailing address

1000 Dutch Ridge Rd
Beaver, PA 15009-9727

Other names 1

  • Ms. Michel Katherine Vasiladiotis Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20181109001063 PA Practitioner - Physician Assistant 7810241809 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA060164PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Facilities, Inc. CurrentSince Oct 3, 2018 Accepting new patients
Valley Medical Facilities Inc CurrentSince Oct 3, 2018 Accepting new patients
Valley Medical Facilities Inc CurrentSince Oct 3, 2018 Accepting new patients
Valley Medical Facilities Inc Past Accepting new patients

Locations

1000 Dutch Ridge Rd
Beaver, PA 15009
Phone (724) 728-7000

25 Heckel Rd
Mc Kees Rocks, PA 15136
Phone (412) 777-6161

720 Blackburn Rd
Sewickley, PA 15143
Phone (412) 741-6600

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1063996361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 DUTCH RIDGE RD",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150099727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 DUTCH RIDGE RD",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150099727",
            "telephone_number": "877-771-4847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOL",
        "first_name": "MICHEL",
        "middle_name": "V",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-21",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA060164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHEL",
            "last_name": "VASILADIOTIS",
            "middle_name": "KATHERINE",
            "prefix": "MS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beaver, PA

Sources for this page

Verify at the official NPI Registry.