Dominic John Nicoletti, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25MP00882300 Issued in NJ

Practice address

65 James St
Edison, NJ 08820-3947

Phone

(732) 321-7000

NPI assigned

Mar 18, 2025

Last updated

Mar 18, 2025By the provider in NPPES

Sex

Male

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1598565541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 NORTON ST",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088792260",
            "telephone_number": "732-882-4763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203947",
            "telephone_number": "732-321-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLETTI",
        "first_name": "DOMINIC",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00882300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Nguyen
• Hung Manh Nguyen, M.D.
• Ryan Nguyen, PHARMD
• Tina D Nguyen, DDS
• Heather Ashley Nicholas, LPC
• Patrick Nierva, D.C.
• Nina Nieves, LSW, LCADC
• Anish Nihalani, M.D.
• Sonam Kumari Nihalani, MD
• Rina Nijhawan, RPH.

• Surgical Physician Assistant in Edison, NJ
• Providers in Edison, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.