Individual provider Active NPI

Nicola A Kemmerer, PA

  • Physician Assistant
  • North Miami Beach, FL
National Provider Identifier
1215113378
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9104311 Issued in FL
Practice address
100 NW 170TH St Ste 208
North Miami Beach, FL 33169-5510
Phone
(305) 405-0045
Fax
(305) 405-0048
NPI assigned
Jan 18, 2008
Last updated
May 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11757 GA
Physician Assistant 363A00000X PA9104311 FL Primary

Addresses

Primary practice location

100 NW 170TH St Ste 208
North Miami Beach, FL 33169-5510

Mailing address

6255 W Sunset Blvd FL 21
Los Angeles, CA 90028-7422
Phone (323) 860-5200

Other practice location 1

735 Piedmont Ave NE
Atlanta, GA 30308-1416
Phone (404) 588-4680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 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
I20081112000311 FL Practitioner - Physician Assistant 8123198975 Reassigns benefits to 1 organization
I20240125001516 GA Practitioner - Physician Assistant 8123198975 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.5 of 100Reported as group
Quality
64.78
Improvement activities
40
Cost
79.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11757GAMDFamily Medicine Physician
PA9104311FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
AIDS Healthcare Foundation CurrentSince May 23, 2009 Accepting new patients
AIDS Healthcare Foundation CurrentSince Jul 8, 2023 Accepting new patients
AIDS Healthcare Foundation CurrentSince May 23, 2009 Accepting new patients

Locations

6255 W Sunset Blvd
Fl 21
Los Angeles, CA 90028
Phone (323) 860-5200

8390 Champions Gate Blvd
Ste 220
Champions Gate, FL 33896
Phone (407) 479-2015

6333 N Federal Hwy
Ste 301302
Ft Lauderdale, FL 33308
Phone (954) 772-2411

100 NW 170th St
Ste 208
North Miami Beach, FL 33169
Phone (305) 405-0045

3135 State Road 580
Ste 1
Safety Harbor, FL 34695
Phone (727) 259-2000

659 Auburn Ave NE
Ste 156
Atlanta, GA 30312
Phone (404) 888-0228

735 Piedmont Ave NE
Atlanta, GA 30308
Phone (404) 588-4680

5700 Hillandale Dr
Ste 100
Lithonia, GA 30058
Phone (770) 593-6684

Interoperability endpoints

  • FHIR API: https://api.ahffhir.com/r4
  • Direct secure messaging: nicola.kemmerer.1@26356.direct.athenahealth.com

Organizations & group practices 5

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": "1200614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1215113378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 W SUNSET BLVD FL 21",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287422",
            "telephone_number": "323-860-5200",
            "fax_number": "234-677-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NW 170TH ST STE 208",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331695510",
            "telephone_number": "305-405-0045",
            "fax_number": "305-405-0048"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "735 Piedmont Ave NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303081416",
            "country_code": "US",
            "telephone_number": "404-588-4680",
            "fax_number": "404-588-4692",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEMMERER",
        "first_name": "NICOLA",
        "middle_name": "A",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-18",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11757",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.