Emily Niccolini, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110009291 Issued in VA

Practice address

4000 Olympia Cir Ste 102
Charlottesville, VA 22911-3614

Phone

(434) 654-8930

NPI assigned

Sep 12, 2022

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

• Emily Kathleen Barr Other name

Medicare fee-for-service enrollment

Enrolled in VA

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

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.

• Martha Jefferson Medical Group LLC

  • Family Medicine Physician
  • Charlottesville, VA
  • NPI 1275720559
  Medicare reassignment
• Martha Jefferson Hospital

  • Endoscopy Clinic/Center
  • Charlottesville, VA
  • NPI 1942189022
  NPD (past)

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1386366995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 OLYMPIA CIR STE 102",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229113614",
            "telephone_number": "434-654-8930",
            "fax_number": "434-204-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 OLYMPIA CIR STE 102",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229113614",
            "telephone_number": "434-654-8930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICCOLINI",
        "first_name": "EMILY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110009291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "BARR",
            "middle_name": "KATHLEEN",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nancy Nguyen
• Samantha Minh Thy Nguyen
• Thanh Phuong Thi Nguyen, MD
• Dung Nguyentran
• Joan Ngwuta, MD
• Thedra E Nichols, FNP
• Brandi T. Nicholson, MD
• Demetrious Tra Nicholson
• Kendra L Nicholson, OT
• Arash Nickkholgh, M.D.

• Physician Assistant in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; 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.