Nicole L Hawk, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00275100 Issued in NJ

Practice address

1210 Route 130 N
Cinnaminson, NJ 08077-3046

Phone

(856) 829-0407

NPI assigned

Dec 7, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carbon Health Medical Group of California PC

  dba Carbon Health

  • Urgent Care Clinic/Center
  • Berkeley, CA
  • NPI 1417294232
  Medicare reassignment NPD
• General Internal Medicine Practice PC

  • Internal Medicine Physician
  • Morton, PA
  • NPI 1255512794
  NPD
• Carbon Health Primary Care of California PC

  • Multi-Specialty Clinic/Center
  • Berkeley, CA
  • NPI 1972057990
  NPD (past)

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1336477124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 ROUTE 130 N",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080773046",
            "telephone_number": "856-829-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 ROUTE 130 N",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080773046",
            "telephone_number": "856-829-0407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 Corte Madera Town Ctr # 303",
            "address_purpose": "LOCATION",
            "city": "Corte Madera",
            "state": "CA",
            "postal_code": "949251207",
            "country_code": "US",
            "telephone_number": "415-840-8615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAWK",
        "first_name": "NICOLE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-07",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA054181",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "55960",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00275100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah V Guzzardo, PT, DPT, PCS
• Hannah Medical Group LLC
• Dane Hardy
• Tehzeeb Hassan, DMD
• Brendan Hastings, MMS, PA-C
• Hamid Hayat, DMD
• Rhonda Lynn Hazell, D.P.M
• Healthmark Counseling, LLC
• Heart of Gold Homecare, LLC
• Heaven's Angels

• Medical Physician Assistant in Cinnaminson, NJ
• Providers in Cinnaminson, NJ by specialty
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.