Individual provider Active NPI

Nicole Michael, PA-C

  • Physician Assistant
  • Reisterstown, MD
National Provider Identifier
1396562146
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0009627 Issued in MD
Practice address
114 Business Center Dr
Reisterstown, MD 21136-1229
Phone
(410) 833-2772
NPI assigned
Sep 23, 2024
Last updated
Nov 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0009627 MD Primary

Addresses

Primary practice location

114 Business Center Dr
Reisterstown, MD 21136-1229

Mailing address

114 Business Center Dr
Reisterstown, MD 21136-1229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20250114002582 MD Practitioner - Physician Assistant 8921536285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maryland Family Care IncGroup PAC ID 5092629394, 157 clinicians

Practice addresses (Care Compare)

114 Business Ctr Dr
Reisterstown, MD 21136-1229
Phone (410) 833-2772

7602 Belair Rd
Baltimore, MD 21236-4088
Phone (410) 663-8100

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: nmichael95778@direct.mdmercy.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764115200000",
    "number": "1396562146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 BUSINESS CENTER DR",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 BUSINESS CENTER DR",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361229",
            "telephone_number": "410-833-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-23",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0009627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reisterstown, MD

Sources for this page

Verify at the official NPI Registry.