Individual provider Active NPI

Nicole Mayers, PA-C

  • Physician Assistant
  • Wilkes Barre, PA
National Provider Identifier
1235957077
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA066034 Issued in PA
Practice address
1155 E Mountain Blvd
Wilkes-Barre, PA 18702
Phone
(570) 808-7300
NPI assigned
Oct 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA066034 PA
Physician Assistant 363A00000X MA066034 PA Primary

Addresses

Primary practice location

1155 E Mountain Blvd
Wilkes-Barre, PA 18702

Mailing address

1155 E Mountain Blvd
Wilkes-Barre, PA 18702

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241220001937 PA Practitioner - Physician Assistant 4486181013 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

1155 E Mountain Blvd
Wilkes Barre, PA 18702-7906
Phone (570) 808-5135

1175 E Mountain Blvd
Suite 150723
Wilkes Barre, PA 18702-7906
Phone (570) 808-1093

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA066034PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger-HM Joint Venture, LLC CurrentSince Dec 16, 2024 Accepting new patients
Geisinger-HM Joint Venture, LLC Physician Assistant CurrentSince Dec 16, 2024 Accepting new patients
Geisinger Clinic CurrentSince Dec 16, 2024 Accepting new patients
Geisinger Clinic CurrentSince Dec 16, 2024 Accepting new patients
Caring Community Health Center Past Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

1020 Thompson St
Jersey Shore, PA 17740
Phone (570) 398-0100

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

255 Route 220 Hwy
Ste 211
Muncy, PA 17756
Phone (570) 368-2870

1201 Oak St
Pittston, PA 18640
Phone (570) 808-9800

132 Abigail Ln
Port Matilda, PA 16870
Phone (814) 272-5011

3 W Olive St
Ste 210A
Scranton, PA 18508
Phone (570) 342-0889

809 Hunter Hwy
Tunkhannock, PA 18657
Phone (570) 966-2700

175 S Wilkes Barre Blvd
Wilkes Barre, PA 18702
Phone (570) 821-0808

25 Church St
Wilkes Barre, PA 18702
Phone (570) 340-5800

Interoperability endpoints

  • Direct secure messaging: nmayers619021@direct.geisinger.edu

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1235957077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 E MOUNTAIN BLVD",
            "city": "WILKES-BARRE",
            "state": "PA",
            "postal_code": "18702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 E MOUNTAIN BLVD",
            "city": "WILKES-BARRE",
            "state": "PA",
            "postal_code": "18702",
            "telephone_number": "570-808-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYERS",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA066034",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA066034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.