Nichole M Palomba, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA120411 Issued in FL

Practice address

5070 Minton Rd NW Ste 3
Palm Bay, FL 32907-1157

Phone

(321) 768-1600

Fax

(321) 799-4903

NPI assigned

Aug 19, 2015

Reactivated

Oct 22, 2025

Last updated

May 4, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Nichole M Rosato Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Shadetree Dermatology LLCGroup PAC ID 8628511227, 6 clinicians

Family Health Center of Worcester, Inc.Group PAC ID 4789670985, shared by 2 NPIs, 94 clinicians

Florida Dermatology Associates IncGroup PAC ID 1557269982, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: nichole.palomba.1@14269.direct.athenahealth.com
• Direct secure messaging: nichole.palomba.2@14269.direct.athenahealth.com
• Direct secure messaging: npalomba47871@direct.ctc.masshiway.net

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.

• Florida Dermatology Associates Inc

  dba Palm Bay Dermatology

  • MOHS-Micrographic Surgery Physician
  • Palm Bay, FL
  • NPI 1073577136
  Medicare reassignment Care Compare group
• Shadetree Dermatology LLC

  • Dermatology Physician
  • Cocoa Beach, FL
  • NPI 1366297376
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1124494661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5070 MINTON RD NW STE 3",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071157",
            "telephone_number": "321-768-1600",
            "fax_number": "321-799-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5070 MINTON RD NW STE 3",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071157",
            "telephone_number": "321-768-1600",
            "fax_number": "321-799-4903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 Queen St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016102473",
            "country_code": "US",
            "telephone_number": "508-860-7700",
            "fax_number": "508-661-3046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALOMBA",
        "first_name": "NICHOLE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-19",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "deactivation_date": "2025-10-02",
        "reactivation_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA120411",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA5551",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "ROSATO",
            "middle_name": "M",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Regina Charlene Palmeri
• Heather M Palonis, CPBT
• Laura Palumbo-Cioffi, LDO
• Patricia Anne Panarese, FNP
• Paradise Hill Home Assisted Living Facility
• Maripi Dolly Parguian, P.T.

• Physician Assistant in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.