Individual provider Active NPI

Nicole Dutzman, PA-C

  • Medical Physician Assistant
  • Exton, PA
National Provider Identifier
1104704196
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA066861 Issued in PA
Practice address
780 W Lincoln Hwy
Exton, PA 19341-2547
Phone
(484) 206-4447
NPI assigned
Aug 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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 MA066861 PA Primary

Addresses

Primary practice location

780 W Lincoln Hwy
Exton, PA 19341-2547

Mailing address

766 W Lincoln Hwy
Exton, PA 19341-2547

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
I20251013001849 PA Practitioner - Physician Assistant 2264929470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Pennsylvania State University College of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

412 Creamery Way
Suite 400
Exton, PA 19341-2551

584 Charles Dr
Downingtown, PA 19335-1786

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA066861PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rheumatology and Arthritis Care Center PLLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

766 W Lincoln Hwy
Exton, PA 19341
Phone (484) 206-4447

780 W Lincoln Hwy
Exton, PA 19341
Phone (610) 873-1188

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCFGDD

Organizations & group practices 1

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": "1756166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1104704196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "766 W LINCOLN HWY",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 W LINCOLN HWY",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412547",
            "telephone_number": "484-206-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTZMAN",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-26",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA066861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Exton, PA

Sources for this page

Verify at the official NPI Registry.