Individual provider Active NPI

Karen Marie Nieradka, P.A.-C

  • Physician Assistant
  • Inverness, FL
National Provider Identifier
1366505786
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2762 Issued in FL
Practice address
131 S Citrus Ave
Inverness, FL 34452-4701
Phone
(813) 997-4219
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110009065 VA
Physician Assistant 363A00000X PA2762 FL Primary

Addresses

Primary practice location

131 S Citrus Ave
Inverness, FL 34452-4701

Mailing address

6006 49TH St N Ste 310
St Petersburg, FL 33709-2149
Phone (727) 527-9779

Other practice location 1

502 W Highland Blvd
Inverness, FL 34452-4720
Phone (813) 997-4219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC, MI, VA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20191125000127 FL Practitioner - Physician Assistant 5496034118 Reassigns benefits to 1 organization
I20200825000492 NC Practitioner - Physician Assistant 5496034118 Reassigns benefits to 1 organization
I20240117000676 MI Practitioner - Physician Assistant 5496034118 Reassigns benefits to 1 organization
I20250818000053 VA Practitioner - Physician Assistant 5496034118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

4000 Wellness Dr
Midland, MI 48670-2000
Phone (989) 633-8018

4500 Campus Ridge Dr
Midland, MI 48640-6123
Phone (989) 837-9250

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110009065VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc CurrentSince Aug 1, 2020 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Jan 8, 2024 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Jan 8, 2024 Accepting new patients
Caromont Medical Group, Inc. CurrentSince Aug 1, 2020 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Jun 1, 2025 Accepting new patients
Cardiology Consultants Past Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

2240 Remount Rd
Gastonia, NC 28054
Phone (704) 671-5311

150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944

Interoperability endpoints

  • Direct secure messaging: karen.nieradka@hca6.eclinicaldirectplus.com
  • Direct secure messaging: knieradkapa345225@carlehiedirect.net

Organizations & group practices 9

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 6

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1366505786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6006 49TH ST N STE 310",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337092149",
            "telephone_number": "727-527-9779",
            "fax_number": "727-522-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 S CITRUS AVE",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344524701",
            "telephone_number": "813-997-4219"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 W Highland Blvd",
            "address_purpose": "LOCATION",
            "city": "Inverness",
            "state": "FL",
            "postal_code": "344524720",
            "country_code": "US",
            "telephone_number": "813-997-4219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIERADKA",
        "first_name": "KAREN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "P.A.-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110009065",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA2762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inverness, FL

Sources for this page

Verify at the official NPI Registry.