Individual provider Active NPI

Nicole Adriana Aprille Guerin, PA-C

  • Physician Assistant
  • Poughkeepsie, NY
National Provider Identifier
1093323065
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
027398 Issued in NY
Practice address
56 Main St
Poughkeepsie, NY 12601-2948
Phone
(845) 485-5000
Fax
(845) 795-8088
NPI assigned
Jul 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5849 CT
Physician Assistant 363A00000X 027398 NY Primary

Addresses

Primary practice location

56 Main St
Poughkeepsie, NY 12601-2948

Mailing address

56 Main St
Poughkeepsie, NY 12601-2948
Phone (845) 485-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220418000807 NY Practitioner - Physician Assistant 3577974013 Reassigns benefits to 2 organizations
I20221012001213 CT Practitioner - Physician Assistant 3577974013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Dermatology, PCGroup PAC ID 8022021732, 40 clinicians

Practice addresses (Care Compare)

969 Main St
Suite D
Fishkill, NY 12524-1791
Phone (845) 896-7730

Merit-based Incentive Payment System (MIPS)

Final score
76.6 of 100Reported as group
Quality
41.5
Improvement activities
40
Cost
100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
027398NYMDSpeech-Language Pathologist

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1093323065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 MAIN ST",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126012948",
            "telephone_number": "845-485-5000",
            "fax_number": "845-795-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 MAIN ST",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126012948",
            "telephone_number": "845-485-5000",
            "fax_number": "845-795-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERIN",
        "first_name": "NICOLE",
        "middle_name": "ADRIANA APRILLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "5849",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.