Nicole Bellhorn, PA-C
Individual provider Active NPI Physician Assistant · New London, CT
NPI 1720926280 · NPPES record last updated May 27, 2026
Key facts
- NPI
- 1720926280
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 23.007604 (CT)
- Practice address
- 365 Montauk Ave
New London, CT 06320-4700 - Phone
- (860) 442-0711
- NPI assigned
- Mar 24, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
99 Hawley Lane - Nemg
CB 3427
Stratford, CT 06614-1202
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260625003068 | CT | Practitioner - Physician Assistant | 6406329960 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23.007604 | CT | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 23.007604 | CT | Yes |
Addresses
Primary practice location
365 Montauk Ave
New London, CT 06320-4700
Mailing address
106 Shell Ave
Milford, CT 06460-6322
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23.007604 | Other | CT | CT PA LICENSE NUMBER |
Other providers in New London, CT
- Talena Bell-Lucas
- Andrew Tristan Bell
- Charlotte Marie Bell
- David N Bellas
- Katherine Card Belleville
- Christopher Bellizzi
- Jenna Lee Bellucci
- Shamal Srirammohan Beltangady
- Joseph C Benedict
- Jill Stockmal Bennett
All providers in New London, CT · Physician Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.