Nicole Faldmo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6548 Issued in AZ

Practice address

1688 E Boston St Ste 101
Gilbert, AZ 85295-6222

Phone

(480) 855-0085

Fax

(480) 855-0086

NPI assigned

Oct 20, 2009

Last updated

Feb 25, 2022By the provider in NPPES

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Desert Sky Dermatology PLLCGroup PAC ID 3971753054, 13 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.32 of 100Reported as group

Quality

99.63

Improvement activities

40

Cost

74.89

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Desert Sky Dermatology, PLLC

  • Dermatology Physician
  • Gilbert, AZ
  • NPI 1871851691
  Medicare reassignment Care Compare group
• Southwest Skin Laboratory PLLC

  • Clinical Medical Laboratory
  • Gilbert, AZ
  • NPI 1124386966
  NPD
• Philip Fried MD PLLC

  • Procedural Dermatology Physician
  • White Plains, NY
  • NPI 1265869077
  NPD (past)

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1679809008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1688 E BOSTON ST STE 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852956222",
            "telephone_number": "480-855-0085",
            "fax_number": "480-855-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1688 E BOSTON ST STE 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852956222",
            "telephone_number": "480-855-0085",
            "fax_number": "480-855-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALDMO",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2022-02-25",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013656",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "Z253585",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Fairbanks
• Michael J Fairfax, D.O.
• Faith Into Action, LLC (Assisting Hands Home Care Gilbert)
• Jihan Fajut
• Robert Wayne Fakler, PA
• Joel Alan Falk, M.D.
• Nicole C Fallacaro, PA
• Rachel Fallacaro
• Emileigh Linda Falterman, SLPA
• Jennifer Olufunmilayo Faluade, APRN, FNP-BC

• Physician Assistant in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.