Individual provider Active NPI

Nicole Alexander, PA-C

  • Physician Assistant
  • Boca Raton, FL
National Provider Identifier
1417346776
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1110 SW 9TH Ave
Boca Raton, FL 33486-5454
Phone
(561) 703-3479
NPI assigned
Jan 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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 Primary

Addresses

Primary practice location

1110 SW 9TH Ave
Boca Raton, FL 33486-5454

Mailing address

1110 SW 9TH Ave
Boca Raton, FL 33486-5454
Phone (561) 703-3479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, FL3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20150407000392 MD Practitioner - Physician Assistant 4880912666 Reassigns benefits to 3 organizations
I20240909003564 DC Practitioner - Physician Assistant 4880912666 Reassigns benefits to 1 organization
I20260225004009 FL Practitioner - Physician Assistant 4880912666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians

Practice addresses (Care Compare)

1 Tampa General Cir
Tampa, FL 33606-3571
Phone (904) 399-5550

2 Tampa General Cir
Tampa, FL 33606-3571
Phone (904) 399-5550

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 399-5550

5 Tampa General Cir
Tampa, FL 33606-3601
Phone (904) 399-5550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Urgent Care, LLC CurrentSince Sep 1, 2024 Accepting new patients
University of Maryland Physicians P.a. CurrentSince Sep 12, 2022 Accepting new patients
Johns Hopkins University CurrentSince Apr 1, 2015 Accepting new patients
Johns Hopkins University CurrentSince Apr 1, 2015 Accepting new patients
University of Maryland Physicians P.a. CurrentSince Sep 12, 2022 Accepting new patients
West Baltimore Emergency Medicine Physicians, LLC Past Accepting new patients

Locations

827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100

4940 Eastern Ave
Baltimore, MD 21224

821 N Eutaw St
Baltimore, MD 21201
Phone (410) 225-9185

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

419 W Redwood St
Baltimore, MD 21201
Phone (410) 328-5196

22750 Newcut Rd
Ste D1B
Clarksburg, MD 20871
Phone (301) 302-8513

9809 Main St
Ste 103
Damascus, MD 20872
Phone (301) 482-1000

Organizations & group practices 10

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 1

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": "1420761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1417346776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 SW 9TH AVE",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334865454",
            "telephone_number": "561-703-3479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 SW 9TH AVE",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334865454",
            "telephone_number": "561-703-3479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "NICOLE",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-09",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.