Individual provider Active NPI

Nicole Briana Vasinko, PA-C

  • Medical Physician Assistant
  • Indiana, PA
National Provider Identifier
1245600337
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA057903 Issued in PA
Practice address
793 Old Route 119 Hwy N
Indiana, PA 15701-1372
Phone
(724) 465-5576
Fax
(724) 465-5532
NPI assigned
Oct 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA057903 PA Primary

Addresses

Primary practice location

793 Old Route 119 Hwy N
Indiana, PA 15701-1372

Mailing address

427 Sawmill Rd
Greensburg, PA 15601-6468
Phone (724) 972-3804

Other identifiers 3

IdentifierTypeStateIssuer
000670775OtherPAOPTUM
13624851OtherPACAQH
103197501OtherPAMA

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
I20170410001213 PA Practitioner - Physician Assistant 0648556415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Guidance CenterGroup PAC ID 7517850720, 15 clinicians

Practice addresses (Care Compare)

600 Leonard St
Clearfield, PA 16830-3247
Phone (814) 765-5337

793 Old Route 119 Hwy N
Indiana, PA 15701-1372
Phone (724) 465-5576

Hospital & facility affiliations

  • Indiana Regional Medical Center Hospital, Indiana, PA, CCN 390173

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Windber Hospital, Inc. Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1245600337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 SAWMILL RD",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156016468",
            "telephone_number": "724-972-3804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "793 OLD ROUTE 119 HWY N",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157011372",
            "telephone_number": "724-465-5576",
            "fax_number": "724-465-5532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASINKO",
        "first_name": "NICOLE",
        "middle_name": "BRIANA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-01",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA057903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM",
            "identifier": "000670775",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13624851",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA",
            "identifier": "103197501",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

Verify at the official NPI Registry.