Emma Nicolli, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA221907 Issued in OR

Practice address

875 Oak St SE Ste 40304050
Salem, OR 97301-3975

Phone

(503) 561-6444

NPI assigned

Jul 16, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Cancer Specialists PCGroup PAC ID 8426943838, 70 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Salem Hospital Hospital, Salem, OR, CCN 380051

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: enicolli395754@direct.salemhealth.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.

• Northwest Cancer Specialists PC

  • Hematology & Oncology Physician
  • Vancouver, WA
  • NPI 1407828114
  Care Compare group
• Oregon Oncology Specialists, LLP

  • Hematology & Oncology Physician
  • McMinnville, OR
  • NPI 1649206780
  NPD
• Oregon Oncology Specialists, LLP

  • Hematology & Oncology Physician
  • Salem, OR
  • NPI 1013953025
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Care Compare affiliation

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1548008345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 HRUBETZ RD SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024880",
            "telephone_number": "636-288-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 OAK ST SE STE 40304050",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013975",
            "telephone_number": "503-561-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLLI",
        "first_name": "EMMA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA221907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Nicholson-Nelson, LCSW, MSW
• Gilbert Earl Nicholson-Nelson, M.S.W., L.C.S.W.
• Jacob Nicholson, N.P.
• Jennifer M Nickell, FNP
• Dulce Rosario Nicolas
• Megan Nicoloff, PSY.D.
• Chunmei Nie, LMT
• Marina Nieblas, QMHA
• Kent Reger Niedens, PHARM.D.
• Kathryn A Nielsen, RN CNM

• Physician Assistant in Salem, OR
• Providers in Salem, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.