Amy Marie Nichols, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9104748 Issued in FL

Practice address

1590 S Congress Ave
West Palm Beach, FL 33406-5957

Phone

(561) 966-1000

Fax

(561) 432-0618

NPI assigned

Aug 7, 2009

Last updated

Mar 17, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Excel Pain and Spine LLCGroup PAC ID 8123447869, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Excel Pain and Spine LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Sun City Center, FL
  • NPI 1063028587
  Medicare reassignment Care Compare group
• Excel Pain and Spine LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Sarasota, FL
  • NPI 1023811619
  NPD

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

{
    "created_epoch": "1249603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1417188475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 S CONGRESS AVE",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334065957",
            "telephone_number": "561-966-1000",
            "fax_number": "561-432-0618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 S CONGRESS AVE",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334065957",
            "telephone_number": "561-966-1000",
            "fax_number": "561-432-0618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-07",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thuong Thuy Truong Nguyen, PSY.D.
• Toan T Nguyen, MD
• Tony Nguyen, PT, DPT
• Truong The Nguyen, PHARMD
• Berkeley Anthony Nicholls, D.M.D.
• Tanya A Nichols, RN CDE
• Cynthia Lubin Nicolas, MA
• Jeanella C Nicolas, ALLIED HEALTH
• Nicole Basile MD PA
• Milagros Nicot Valenciano

• Medical Physician Assistant in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.