Nicolle Segarra, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00633800 Issued in NJ

Practice address

95 Northfield Ave
West Orange, NJ 07052-4731

Phone

(973) 325-2266

NPI assigned

Dec 18, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Am PM Walk in Urgent Care ClinicGroup PAC ID 5092954602, 79 clinicians

Zufall Health Center, IncGroup PAC ID 2365448461, shared by 10 NPIs, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Am PM Walk in Urgent Care Clinic

  • Urgent Care Clinic/Center
  • Bergenfield, NJ
  • NPI 1073853859

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• The Radiology Group of New Jersey, LLC

  dba The Medical Group of New Jersey

  • Multi-Specialty Clinic/Center
  • Hackettstown, NJ
  • NPI 1174010540
  Medicare reassignment NPD
• Am PM Primary Care

  • Primary Care Clinic/Center
  • Bergenfield, NJ
  • NPI 1083045694

  Multi-Specialty

  NPD (past)
• Monmouth Digestive Health LLC

  • Gastroenterology Physician
  • Eatontown, NJ
  • NPI 1831721232

  Multi-Specialty

  NPD (past)
• Zufall Health Center,Inc

  • Community Health Clinic/Center
  • Dover, NJ
  • NPI 1902990880
  NPD (past)

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1417595638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 SHERIDAN DR APT 12",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "015453839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 NORTHFIELD AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524731",
            "telephone_number": "973-325-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGARRA",
        "first_name": "NICOLLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-18",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00633800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Scott-Harris, RDN
• Renee Coretta Scott
• Judith L Seavy, AUDIOLOGIST
• Desiree L.D. Seburn-Williamson
• Candace Kyriaki Sedereas, DPT
• Mark H Seglin, PH.D.
• Savannah Segovia, CD
• Michael K Seidenstein, M.D.
• Mia Capozella Seiger, DMD
• Danielle Seltzer, MD

• Medical Physician Assistant in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; 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.