Individual provider Active NPI

Camryn Nichols

  • Physician Assistant
  • Syosset, NY
National Provider Identifier
1437988235
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
032644 Issued in NY
Practice address
314 Jackson Ave
Syosset, NY 11791-4124
Phone
(516) 998-5292
NPI assigned
Jul 30, 2024
Last updated
Oct 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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 032644 NY Primary

Addresses

Primary practice location

314 Jackson Ave
Syosset, NY 11791-4124

Mailing address

314 Jackson Ave
Syosset, NY 11791-4124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20241113001031 NY Practitioner - Physician Assistant 5799219739 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Francis HospitalGroup PAC ID 9234101221, 96 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone (631) 669-2255

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032644NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Hospital CurrentSince Dec 1, 2024 Accepting new patients
Good Samaritan Hospital Medical CurrentSince Dec 1, 2024 Accepting new patients
St Francis Hospital United States Catholic Conference CurrentSince Dec 1, 2024 Accepting new patients

Locations

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 8

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": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1437988235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 JACKSON AVE",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 JACKSON AVE",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914124",
            "telephone_number": "516-998-5292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "CAMRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-30",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "032644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

Verify at the official NPI Registry.