Active NPI
Nicole Lee Hoffman, PA-C
- Physician Assistant
- Philadelphia, PA
National Provider Identifier
1215305628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA057776
- Practice address
- 10800 Knights Rd
Philadelphia, PA 19114-4200 - Phone
- (215) 612-4963
- Fax
- (215) 612-4532
- NPI assigned
- Sep 2, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | OA003610 | PA | |
| Physician Assistant | 363A00000X | MA057776 | PA | Primary |
Addresses
Primary practice location
10800 Knights Rd
Philadelphia, PA 19114-4200
Mailing address
10 North Dr
Tabernacle, NJ 08088-8657
Phone (609) 760-6092
Other practice location 1
130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone (484) 337-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA057776 | PA | MD | Physician Assistant |
| OA003610 | PA | MD | Physician Assistant |
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 and National Provider Directory roles.
-
- Emergency Medicine Physician
- Paoli, PA
- NPI 1316919368
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564963200000",
"number": "1215305628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 NORTH DR",
"city": "TABERNACLE",
"state": "NJ",
"postal_code": "080888657",
"telephone_number": "609-760-6092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10800 KNIGHTS RD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191144200",
"telephone_number": "215-612-4963",
"fax_number": "215-612-4532"
}
],
"practiceLocations": [
{
"address_1": "130 S Bryn Mawr Ave",
"address_purpose": "LOCATION",
"city": "Bryn Mawr",
"state": "PA",
"postal_code": "190103121",
"country_code": "US",
"telephone_number": "484-337-3000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOFFMAN",
"first_name": "NICOLE",
"middle_name": "LEE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-02",
"last_updated": "2019-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "OA003610",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA057776",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.