Individual provider Active NPI

Nicole Kathleen Newcomb, PA-C, ASW

  • Medical Physician Assistant
  • Santee, CA
National Provider Identifier
1265864268
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA56882 Issued in CA
Practice address
278 Town Center Pkwy
Ste 105 (S90)
Santee, CA 92071-5800
Phone
(619) 713-7880
NPI assigned
Aug 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW62470 CA
Medical Physician Assistant 363AM0700X PA56882 CA Primary

Addresses

Primary practice location

278 Town Center Pkwy
Ste 105 (S90)
Santee, CA 92071-5800

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (858) 605-7171

Other practice location 1

3002 Armstrong St
San Diego, CA 92111-5702
Phone (858) 634-8319

Other practice location 2

12170 Orgren Ave
Chino, CA 91710-2115
Phone (951) 818-1781

Other names 1

  • Nicole Kathol Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20190829000931 CA Practitioner - Physician Assistant 4284962267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Southern California Keck School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

278 Town Ctr Pkwy
Suite 105
Santee, CA 92071-5809
Phone (619) 713-7880

9888 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9896 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9898 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 455-9100

Hospital & facility affiliations

  • Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077
  • Scripps Green Hospital Hospital, La Jolla, CA, CCN 050424

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ASW62470CAMDMental Health Counselor
56882CAMDDentist
PA56882CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health CurrentSince Aug 1, 2019 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Aug 1, 2019 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Current Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10790 Rancho Bernardo Rd
#4S205
San Diego, CA 92127
Phone (858) 605-7171

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

278 Town Center Pkwy
Ste 105
Santee, CA 92071
Phone (619) 449-6621

Interoperability endpoints

  • Direct secure messaging: nkathol317929@scrippshlth.medalliesdirect.net

Organizations & group practices 6

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 2

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": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1265864268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-605-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 TOWN CENTER PKWY",
            "address_2": "STE 105 (S90)",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920715800",
            "telephone_number": "619-713-7880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3002 Armstrong St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921115702",
            "country_code": "US",
            "telephone_number": "858-634-8319",
            "fax_number": "858-279-2412",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12170 Orgren Ave",
            "address_purpose": "LOCATION",
            "city": "Chino",
            "state": "CA",
            "postal_code": "917102115",
            "country_code": "US",
            "telephone_number": "951-818-1781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEWCOMB",
        "first_name": "NICOLE",
        "middle_name": "KATHLEEN",
        "credential": "PA-C, ASW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-01",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW62470",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA56882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "KATHOL",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Santee, CA

Sources for this page

Verify at the official NPI Registry.