Nicolette Van Horn

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

016467 Issued in NY

Practice address

921 Wayne St
Olean, NY 14760-2255

Phone

(716) 379-8600

NPI assigned

Mar 2, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Nicolette Coyne Former name

Medicare fee-for-service enrollment

Enrolled in DC

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medstar Urgent Care LLCGroup PAC ID 9335303155, 300 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Medstar Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Wheaton, MD
  • NPI 1871843409

  DC

  Medicare reassignment Care Compare group
• Medstar Urgent Care LLC

  • General Practice Physician
  • Lexington Park, MD
  • NPI 1275410474
  NPD
• Medstar Urgent Care LLC

  • Urgent Care Clinic/Center
  • Baltimore, MD
  • NPI 1942623319
  NPD

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

{
    "created_epoch": "1393718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1295150142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 PARK CLUB LN",
            "address_2": "SUITE 300",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215269",
            "telephone_number": "716-836-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 WAYNE ST",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147602255",
            "telephone_number": "716-379-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN HORN",
        "first_name": "NICOLETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-02",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016467",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA003024",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLETTE",
            "last_name": "COYNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christa Tuttle
• Twin Valley Physical Therapy PLLC
• Matthew Tyssee
• Kuldesh Singh Ubhi, M.D.
• Jennifer L Ursoy, PA-C
• James Craig Vandewall, MD
• Patrina M Vansickle, MSW
• Sarah M Vanskiver
• Jacob Vecchio
• Victor Anthony Vena, RPH

• Physician Assistant in Olean, NY
• Providers in Olean, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.