Individual provider Active NPI

Nicole Elizabeth Habjan, PA-C

  • Medical Physician Assistant
  • Pittsburgh, PA
National Provider Identifier
1306610498
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA065178 Issued in PA
Practice address
4401 Penn Ave
Pittsburgh, PA 15224-1334
Phone
(412) 692-5170
NPI assigned
Nov 9, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 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 MA065178 PA Primary

Addresses

Primary practice location

4401 Penn Ave
Pittsburgh, PA 15224-1334

Mailing address

4401 Penn Ave
Pittsburgh, PA 15224-1334

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
I20240524001099 PA Practitioner - Physician Assistant 2769834548 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA065178PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians Pediatric Endocrinology CurrentSince Apr 13, 2024 Accepting new patients
University of Pittsburgh Physicians CurrentSince Apr 13, 2024 Accepting new patients
Upmc Emergency Medicine Inc Past Accepting new patients

Locations

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

4401 Penn Ave
Pittsburgh, PA 15224
Phone (412) 692-5030

519 Penn Ave
Ste 206
Turtle Creek, PA 15145
Phone (412) 823-3121

Organizations & group practices 4

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": "1699488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1306610498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 PENN AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 PENN AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241334",
            "telephone_number": "412-692-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABJAN",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-09",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA065178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.