Individual provider Active NPI

Nicholaus Pierce Carranza, PA-C

  • Medical Physician Assistant
  • Warren, PA
National Provider Identifier
1104588995
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
OA005790 Issued in PA
Practice address
2 W Crescent Park
Warren, PA 16365-2199
Phone
(814) 723-4973
NPI assigned
Oct 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X OA005790 PA Primary

Addresses

Primary practice location

2 W Crescent Park
Warren, PA 16365-2199

Mailing address

134 Eckstein LN
Harmony, PA 16037-8826
Phone (814) 207-1128

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
I20211116000447 PA Practitioner - Physician Assistant 5799174611 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.59 of 100Reported as group
Quality
88.93
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
83.74 of 100Reported as group
Quality
78.36
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
99 of 100Reported as group
Quality
95.9
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OA005790PAMDMedical Physician Assistant

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1104588995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 ECKSTEIN LN",
            "city": "HARMONY",
            "state": "PA",
            "postal_code": "160378826",
            "telephone_number": "814-207-1128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 W CRESCENT PARK",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652199",
            "telephone_number": "814-723-4973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRANZA",
        "first_name": "NICHOLAUS",
        "middle_name": "PIERCE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-08",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA005790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, PA

Sources for this page

Verify at the official NPI Registry.