Nicholas Anzideo, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1010 Horsham Rd Ste 201
North Wales, PA 19454-1500

Phone

(215) 362-2385

Fax

(215) 361-1584

NPI assigned

Nov 12, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Dermatology of Pennsylvania, PCGroup PAC ID 5799091690, 29 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.23 of 100Reported as group

Quality

95.33

Promoting interoperability

86

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicholasanzideo@connollydermatology.emadirect.md

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.

• Advanced Dermatology of Pennsylvania, PC

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1740671767
  Medicare reassignment Care Compare group
• Connolly Dermatology Philadelphia LLC

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1659976082
  Medicare reassignment
• Reconstructive Orthopaedic Associates II LLC

  dba Rothman Orthopaedics Institute

  • Orthopaedic Surgery Physician
  • Philadelphia, PA
  • NPI 1861433278
  Medicare reassignment
• Coyle S Connolly DO PA

  • Dermatology Physician
  • Linwood, NJ
  • NPI 1053367516

  PA

  Medicare reassignment
• Rothman Orthopaedics of New Jersey, LLC

  dba Rothman Orthopaedics Institute

  • Orthopaedic Surgery Physician
  • Marlton, NJ
  • NPI 1215978630
  Medicare reassignment
• Reconstructive Orthopaedic Associates II LLC

  dba Rothman Orthopaedics Institute

  • Prosthetic/Orthotic Supplier
  • Philadelphia, PA
  • NPI 1497571830
  NPD
• Rothman Institute of New Jersey, P.a.

  • Prosthetic/Orthotic Supplier
  • Manahawkin, NJ
  • NPI 1831611243
  NPD

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

{
    "created_epoch": "1447286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1629441696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 WHITTIER DR",
            "city": "WARMINSTER",
            "state": "PA",
            "postal_code": "189742059",
            "telephone_number": "215-840-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 HORSHAM RD STE 201",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194541500",
            "telephone_number": "215-362-2385",
            "fax_number": "215-361-1584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2099 New Albany Rd",
            "address_purpose": "LOCATION",
            "city": "Cinnaminson",
            "state": "NJ",
            "postal_code": "080773534",
            "country_code": "US",
            "telephone_number": "609-926-8899",
            "fax_number": "856-772-1997",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "409 Route 70 E",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080342413",
            "country_code": "US",
            "telephone_number": "609-926-8899",
            "fax_number": "856-528-2351",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2418 E York St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191253006",
            "country_code": "US",
            "telephone_number": "609-926-8899",
            "fax_number": "856-772-1997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANZIDEO",
        "first_name": "NICHOLAS",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-12",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00518300",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA058011",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA003706",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mira Amin
• Natalie Rose Andinolfi, IBCLC
• Ahtia Andrews
• Leah Andrews
• Lateefa Antrom, CRNP
• Apple Family Dentistry
• Arlene M. Lavner
• Jennifer Ashley Arno, PHARMD
• Christiane L. Arsever, MD
• Eugene Asonye

• Physician Assistant in North Wales, PA
• Providers in North Wales, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.