Active NPI
Philip Christopher Nicotera, PA-C
- Surgical Physician Assistant
- Palm Harbor, FL
National Provider Identifier
1114222056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA9105548
- Practice address
- 2673 Westcott Cir
Palm Harbor, FL 34684-1746 - Phone
- (850) 445-8429
- NPI assigned
- Jan 25, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA9105548 | FL | Primary |
Addresses
Primary practice location
2673 Westcott Cir
Palm Harbor, FL 34684-1746
Mailing address
2673 Westcott Cir
Palm Harbor, FL 34684-1746
Phone (850) 445-8429
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9105548 | FL | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295913600000",
"number": "1114222056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2673 WESTCOTT CIR",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "346841746",
"telephone_number": "850-445-8429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2673 WESTCOTT CIR",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "346841746",
"telephone_number": "850-445-8429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICOTERA",
"first_name": "PHILIP",
"middle_name": "CHRISTOPHER",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-01-25",
"last_updated": "2011-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "FL",
"license": "PA9105548",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Harbor, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.