Individual provider Active NPI

Nicole Rae Newman, PA-C

  • Physician Assistant
  • Corona, CA
National Provider Identifier
1184802332
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16035 Issued in CA
Practice address
2250 S Main St
Ste. 106
Corona, CA 92882-2534
Phone
(951) 371-2703
Fax
(951) 739-6150
NPI assigned
Feb 8, 2008
Last updated
Aug 20, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

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 PA16035 CA Primary

Addresses

Primary practice location

2250 S Main St
Ste. 106
Corona, CA 92882-2534

Mailing address

2250 S Main St
Ste. 106
Corona, CA 92882-2534
Phone (951) 371-2703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200114003196 CA Practitioner - Physician Assistant 1557594512 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA16035CAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: nicole.newman.p1@direct.cvma.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1202428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1184802332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 S MAIN ST",
            "address_2": "STE. 106",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822534",
            "telephone_number": "951-371-2703",
            "fax_number": "951-739-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 S MAIN ST",
            "address_2": "STE. 106",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822534",
            "telephone_number": "951-371-2703",
            "fax_number": "951-739-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "NICOLE",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-08",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.