Marisa Leigh Nichols, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601012050 Issued in MI

Practice address

23077 Greenfield Rd Ste 253
Southfield, MI 48075-3750

Phone

(248) 559-5950

Fax

(248) 559-2103

NPI assigned

Sep 13, 2023

Last updated

May 12, 2025By the provider in NPPES

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

• Marisa Leigh Pszczolkowski Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• New Horizon Pediatric Care P.C.

  • Pediatrics Physician
  • Southfield, MI
  • NPI 1518017664
  NPD (past)

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1518744499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9919 BERWYN",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482392120",
            "telephone_number": "734-386-9425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23077 GREENFIELD RD STE 253",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753750",
            "telephone_number": "248-559-5950",
            "fax_number": "248-559-2103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6001 W Outer Dr Ste 340",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482352626",
            "country_code": "US",
            "telephone_number": "313-341-8166",
            "fax_number": "313-341-8231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "MARISA",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-13",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISA",
            "last_name": "PSZCZOLKOWSKI",
            "middle_name": "LEIGH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jane W Ngumo, FNP
• Meiko Khai My Nguyen
• Qui Nguyen
• Madeleine Claire Nicholas, DO
• Karen Nichols, BSW
• Carolyn J. Nicholson, LMSW
• Breanna Nicks
• Nicole Guza Counseling PLLC
• Nicole Rothenberg MD PLLC
• Janae Niedzwiecki

• Physician Assistant in Southfield, MI
• Providers in Southfield, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.