Nicole Minnick, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9110085 Issued in FL

Practice address

300 Pinellas St # Ms 36
Clearwater, FL 33756-3804

Phone

(727) 251-4112

NPI assigned

Jan 25, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole Pruse Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Bay Area Emergency Physicians LLC

  • Emergency Medicine Physician
  • Clearwater, FL
  • NPI 1164459095
  Medicare reassignment
• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment
• FL-I Medical Services, LLC

  • Nurse Practitioner
  • Fort Pierce, FL
  • NPI 1750655106
  Medicare reassignment
• Pasco County Emergency Physicians LLC

  • Emergency Medicine Physician
  • New Port Richey, FL
  • NPI 1568771707
  Medicare reassignment
• FL-I Medical Services LLC

  • Physician Assistant
  • Haines City, FL
  • NPI 1285356790
  NPD
• FL-I Medical Services, PA

  • Nurse Practitioner
  • Okeechobee, FL
  • NPI 1376818500

  Physician Assistant

  NPD

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1679010862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PINELLAS ST # MS 36",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563804",
            "telephone_number": "727-251-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PINELLAS ST # MS 36",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563804",
            "telephone_number": "727-251-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNICK",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9110085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "PRUSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mindful Nutrition RDN LLC
• Mindful Sunshine Wellness, P.a.
• Mindworks on Call
• Donald J Miner, CRNA
• David I Minkoff, MD
• Paula Minnick, CME
• Regina Marie Minogue, CRDH
• Gabrielle Minoprio
• Minuteclinic LLC
• Stacey Malinda Miozzi

• Physician Assistant in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.