Individual provider Active NPI

Nicole L Piedimonte, PA-C

  • Medical Physician Assistant
  • Orlando, FL
National Provider Identifier
1376975565
Registry record updated Sep 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA13351 Issued in TX
Practice address
10743 Narcoossee Road
Suite a-18
Orlando, FL 32832
Phone
(407) 277-1900
Fax
(407) 277-1888
NPI assigned
Jul 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2020

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 PA13351 TX Primary

Addresses

Primary practice location

10743 Narcoossee Road
Suite a-18
Orlando, FL 32832

Mailing address

7850 Crosswater TRL
Apt 2 -206
Windermere, FL 34786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200917001762 TX Practitioner - Physician Assistant 4789808742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smithson Valley Family Medicine, LLPGroup PAC ID 3779597927, 6 clinicians

Practice addresses (Care Compare)

6098 FM
Suite 311
Spring Branch, TX 78070-7253
Phone (830) 885-5541

Hospital & facility affiliations

  • Christus Santa Rosa Hospital-San Marcos Hospital, San Marcos, TX, CCN 450272
  • Resolute Health Hospital Hospital, New Braunfels, TX, CCN 670098

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: daniel.newbrander.d1.p1@direct.gefcc.nextgenshare.com

Organizations & group practices 1

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 3

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": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599436800000",
    "number": "1376975565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7850 CROSSWATER TRL",
            "address_2": "APT 2 -206",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "34786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10743 NARCOOSSEE ROAD",
            "address_2": "SUITE A-18",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32832",
            "telephone_number": "407-277-1900",
            "fax_number": "407-277-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIEDIMONTE",
        "first_name": "NICOLE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-30",
        "last_updated": "2020-09-07",
        "certification_date": "2020-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA13351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.