Individual provider Active NPI

Lori Ann Nikolic, PA-C ND

  • Physician Assistant
  • Sarasota, FL
National Provider Identifier
1740255579
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9102650 Issued in FL
Practice address
2830 Bee Ridge Rd
Sarasota, FL 34239-7115
Phone
(941) 927-1234
Fax
(941) 921-0043
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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 PA9102650 FL Primary

Addresses

Primary practice location

2830 Bee Ridge Rd
Sarasota, FL 34239-7115

Mailing address

2830 Bee Ridge Rd
Sarasota, FL 34239-7115
Phone (941) 927-1234

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
I20040603000873 FL Practitioner - Physician Assistant 4183606114 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9102650FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hni Medical Services of Florida, LLC CurrentSince Nov 1, 2018 Accepting new patients
Sarasota Emergency Associates PA Past Accepting new patients
Gulf Coast Emergency Physicians PA Past Accepting new patients
Ella Varney MD PHD LLC PastSince Aug 1, 2021 Accepting new patients
VMD Primary Providers Central Florida PLLC PastSince May 8, 2022 Accepting new patients

Locations

900 N Robert Ave
Arcadia, FL 34266
Phone (863) 494-8426

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

5731 Bee Ridge Rd
Sarasota, FL 34233
Phone (888) 221-2216

Organizations & group practices 5

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1740255579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 BEE RIDGE RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342397115",
            "telephone_number": "941-927-1234",
            "fax_number": "941-921-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 BEE RIDGE RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342397115",
            "telephone_number": "941-927-1234",
            "fax_number": "941-921-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKOLIC",
        "first_name": "LORI",
        "middle_name": "ANN",
        "credential": "PA-C ND",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.