Individual provider Active NPI

Nicole Meyer, PA

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1124895115
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10676 Issued in AZ
Practice address
3030 N Central Ave Ste 803
Phoenix, AZ 85012-3054
Phone
(602) 541-1575
NPI assigned
Dec 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10676 AZ Primary

Addresses

Primary practice location

3030 N Central Ave Ste 803
Phoenix, AZ 85012-3054

Mailing address

3030 N Central Ave Ste 803
Phoenix, AZ 85012-3054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CA2 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
I20250106003576 AZ Practitioner - Physician Assistant 0042748972 Reassigns benefits to 1 organization
I20260121002548 CA Practitioner - Physician Assistant 0042748972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Digestive Institute of Arizona PLLC 11 clinicians
Hoag Clinic 447 clinicians

Practice addresses (Care Compare)

3011 S Lindsay Rd
Suite 115
Gilbert, AZ 85295-4332

3011 S Lindsay Rd
Suite 115
Gilbert, AZ 85295-4334
Phone (602) 249-8578

500 Superior Ave
Suite 315
Newport Beach, CA 92663-3660
Phone (949) 764-8191

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67250CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Hoag Clinic CurrentSince Jan 19, 2026 Accepting new patients

Locations

500 Superior Ave
Ste 315
Newport Beach, CA 92663
Phone (949) 764-7277

1031 Avenida Pico
Ste 204
San Clemente, CA 92673
Phone (949) 829-5533

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1124895115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 N CENTRAL AVE STE 803",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850123054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 N CENTRAL AVE STE 803",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850123054",
            "telephone_number": "602-541-1575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-08",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.