Nichole Kycia, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3117 Issued in CT

Practice address

460 Hartford Tpke
Vernon, CT 06066-4845

Phone

(860) 872-6229

NPI assigned

Jul 19, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nichole Stack Other name

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nichole.kycia@xdr.hhchealthdirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Appleseed Pediatric and Adolescent Medicine

  • Pediatrics Physician
  • Middletown, CT
  • NPI 1407422934
  NPD Authorized official
• Prospect CT Medical Foundation, Inc.

  • Family Medicine Physician
  • Manchester, CT
  • NPI 1144677568
  Medicare reassignment

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

{
    "created_epoch": "1405728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405728000000",
    "number": "1487061669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 HARTFORD TPKE",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664845",
            "telephone_number": "860-872-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 HARTFORD TPKE",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664845",
            "telephone_number": "860-872-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYCIA",
        "first_name": "NICHOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-19",
        "last_updated": "2014-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "3117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "STACK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Gary Kovachi, LMFT
• David Micah Kruger, MD
• Ellen Kruzyk
• Shweta Kumar, M.D.
• Kimberly Kunz
• Stacey Elizabeth Labarre
• Talia Lachcik, FNP-C
• Erin Ladue
• Jerome E Lahman, M.D.
• Jeffrey Philip Lahrmann, M.D.

• Physician Assistant in Vernon, CT
• Providers in Vernon, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.