Nicholas Collins, PA-C, L.AC., DIPLOM.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA22910 Issued in CA

Practice address

2300 Henry Ave
Pinole, CA 94564-1714

Phone

(510) 847-0879

NPI assigned

Jan 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Merit-based Incentive Payment System (MIPS)

Final score

12 of 100Reported as individual

Quality

0

Promoting interoperability

0

Improvement activities

0

Cost

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• SNF Specialists Medical Corporation

  • Internal Medicine Physician
  • Fairfield, CA
  • NPI 1497265565
  Medicare reassignment

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

{
    "created_epoch": "1168041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1669520854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 BRUNELL DR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946024104",
            "telephone_number": "510-847-0879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HENRY AVE",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945641714",
            "telephone_number": "510-847-0879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "NICHOLAS",
        "credential": "PA-C, L.AC., DIPLOM.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-06",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "10162",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED PHYSICIAN ASSISTANT CALIFORNIA",
            "identifier": "PA22910",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA ACUPUNCTURE BOARD",
            "identifier": "AC10162",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lewis Clayman, D.M.D., M.D.
• Yvonne Carlisa Cobbs, DNP, ANP-C, PHN. RN
• Katherine Elizabeth Coder
• Carey Cogan, LCSW
• Davida Diane Cohen, MFT
• Concepcion-Manalo Physical Therapy Inc.
• Grace Connolly
• Michael Cote
• Steven John Daniels, MSN, CRNA
• Preeti N. Dave, MD

• Physician Assistant in Pinole, CA
• Providers in Pinole, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; 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.