Nicole Elizabeth Vincelette, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2841 Issued in AZ

Practice address

4980 S Alma School Rd
Suite A2-130
Chandler, AZ 85248-5545

Phone

(480) 215-3035

NPI assigned

Jul 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Nicole Elizabeth Hornung Former name

Medicare fee-for-service enrollment

Enrolled in AZ

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Baywood Medical Center Hospital, Mesa, AZ, CCN 030088
• Mercy Gilbert Medical Center Hospital, Gilbert, AZ, CCN 030119

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Physician Assistant - Surgical Assist, LLC

  • Surgical Physician Assistant
  • Chandler, AZ
  • NPI 1942579750
  Medicare reassignment Authorized official

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

• Banner Baywood Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1194758284
  Care Compare affiliation
• Dignity Health

  • General Acute Care Hospital
  • Gilbert, AZ
  • NPI 1992735088
  Care Compare affiliation

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1215955059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4980 S ALMA SCHOOL RD",
            "address_2": "SUITE A2-130",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852485545",
            "telephone_number": "480-215-3035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4980 S ALMA SCHOOL RD",
            "address_2": "SUITE A2-130",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852485545",
            "telephone_number": "480-215-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCELETTE",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137146",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "HORNUNG",
            "middle_name": "ELIZABETH",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mellizza Anatalio Villamil, NP
• Shanan Marie Villarreal, M.S. CCC-SLP
• Diana Villarruel
• Alejandra Villegas Escobedo
• Rizaldy J Villegas, MD
• Anant Vinjamoori, M.D.
• Pavan Vinjamoori, PHARMD
• Kaitlyn Mackenzie Vinton, FNP
• John William Virga, P.T., M.S.P.T.
• Virtual Scientific Inc

• Physician Assistant in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; 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.