Individual provider Active NPI

Penelope A. McNicholas, RPA-C

  • Physician Assistant
  • Mineola, NY
National Provider Identifier
1801830013
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005528 Issued in NY
Practice address
259 1St St
Mineola, NY 11501-3957
Phone
(516) 663-2727
Fax
(516) 663-8549
NPI assigned
Jun 16, 2006
Last updated
Oct 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 005528 NY Primary
Physician Assistant 363A00000X 25MP00447600 NJ

Addresses

Primary practice location

259 1St St
Mineola, NY 11501-3957

Mailing address

700 Hicksville Rd Ste 204
Bethpage, NY 11714-3472
Phone (516) 576-5812

Other practice location 1

2317 Route 22 Ctr
Union, NJ 07083-8558
Phone (201) 354-1951

Other practice location 2

1345 Avenue Of The Americas
New York, NY 10105-0302
Phone (844) 824-8963

Other names 1

  • Ms. Penelope A Murray Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, CT3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20050326000042 NY Practitioner - Physician Assistant 6709832371 Reassigns benefits to 5 organizations
I20180130002070 NJ Practitioner - Physician Assistant 6709832371 Reassigns benefits to 1 organization
I20241028001565 CT Practitioner - Physician Assistant 6709832371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

336 E 86TH St
New York, NY 10028-4615
Phone (212) 772-3627

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Dec 12, 2019 Accepting new patients
North Shore-Lij Medical PC CurrentSince Oct 28, 2019 Accepting new patients
St. Francis Hospital CurrentSince Oct 1, 2021 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Sep 21, 2016 Accepting new patients
St Francis Hospital United States Catholic Conference CurrentSince Oct 1, 2021 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Sep 30, 2024 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Sep 21, 2016 Accepting new patients
Summit Medical Group PA CurrentSince Dec 12, 2019 Accepting new patients

Locations

506 Westport Ave
Norwalk, CT 06851
Phone (203) 706-4170

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

300 Community Dr
Manhasset, NY 11030

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

1345 Avenue of the Americas
Fl 8
New York, NY 10105
Phone (212) 913-0828

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

1345 Rxr Plz
Uniondale, NY 11556
Phone (516) 453-0435

1345 Rxr Plz
Fl 13
Uniondale, NY 11556
Phone (516) 453-0435

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Interoperability endpoints

  • Direct secure messaging: penelope.mcnicholas.1@2983.direct.athenahealth.com
  • Direct secure messaging: penelope.mcnicholas.2@2983.direct.athenahealth.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1801830013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 HICKSVILLE RD STE 204",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117143472",
            "telephone_number": "516-576-5812",
            "fax_number": "516-576-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 1ST ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013957",
            "telephone_number": "516-663-2727",
            "fax_number": "516-663-8549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2317 Route 22 Ctr",
            "address_purpose": "LOCATION",
            "city": "Union",
            "state": "NJ",
            "postal_code": "070838558",
            "country_code": "US",
            "telephone_number": "201-354-1951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1345 Avenue Of The Americas",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "101050302",
            "country_code": "US",
            "telephone_number": "844-824-8963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCNICHOLAS",
        "first_name": "PENELOPE",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005528",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00447600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENELOPE",
            "last_name": "MURRAY",
            "middle_name": "A",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.