Individual provider Active NPI

Nicholas Val Manocchio, PA

  • Physician Assistant
  • Pompano Beach, FL
National Provider Identifier
1669325957
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9121411 Issued in FL
Practice address
2467 SE 15TH St
Pompano Beach, FL 33062-7503
Phone
(954) 632-3352
NPI assigned
Feb 17, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9121411 FL Primary

Addresses

Primary practice location

2467 SE 15TH St
Pompano Beach, FL 33062-7503

Mailing address

PO Box 20802
Belfast, ME 04915-4105
Phone (469) 803-3000

Other practice location 1

550 Heritage Dr Ste 150
Jupiter, FL 33458-3033
Phone (561) 954-5511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20260602003905 FL Practitioner - Physician Assistant 6901377712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Florida International Univ, College of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14201 Dallas Pkwy
Dallas, TX 75254-2916

PO Box
Belfast, ME 04915

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9121411FLMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1771286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1669325957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20802",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154105",
            "telephone_number": "469-803-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2467 SE 15TH ST",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330627503",
            "telephone_number": "954-632-3352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Heritage Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "Jupiter",
            "state": "FL",
            "postal_code": "334583033",
            "country_code": "US",
            "telephone_number": "561-954-5511",
            "fax_number": "561-658-4650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANOCCHIO",
        "first_name": "NICHOLAS",
        "middle_name": "VAL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-02-17",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9121411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

Verify at the official NPI Registry.