Individual provider Active NPI

Nicole Michelle Roberts, PA-C

  • Physician Assistant
  • Lancaster, PA
National Provider Identifier
1811283153
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA003101L Issued in PA
Practice address
1625 Oregon Pike
Lancaster, PA 17601-4335
Phone
(717) 925-2995
NPI assigned
Jun 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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 MA003101L PA Primary

Addresses

Primary practice location

1625 Oregon Pike
Lancaster, PA 17601-4335

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263

Other practice location 1

1991 Sproul Rd
Suite 625
Broomall, PA 19008-3512
Phone (484) 421-1669

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address PAExchange@patientfirstclinics.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20151005003079 PA Practitioner - Physician Assistant 6406164813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

107 S Sporting Hill Rd
Mechanicsburg, PA 17050-3058
Phone (717) 943-1781

1625 Oregon Pike
Lancaster, PA 17601-4335
Phone (717) 925-2995

2960 E Market St
York, PA 17402-2414
Phone (717) 751-2483

5125 Jonestown Rd
Suite 105
Harrisburg, PA 17112-2987
Phone (717) 943-1566

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA003101LPAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Pennsylvania Medical Group PLLC CurrentSince Feb 16, 2018 Accepting new patients
Patient First Pennsylvania Medical Group PLLC CurrentSince Feb 16, 2018 Accepting new patients

Locations

5125 Jonestown Rd
Ste 105
Harrisburg, PA 17112
Phone (717) 943-1566

1625 Oregon Pike
Lancaster, PA 17601
Phone (717) 925-2995

713 Bethlehem Pike
Montgomeryvle, PA 18936
Phone (267) 695-3944

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

Interoperability endpoints

  • Direct secure messaging: paexchange@patientfirstclinics.com

Organizations & group practices 2

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": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1811283153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 OREGON PIKE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176014335",
            "telephone_number": "717-925-2995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1991 Sproul Rd",
            "address_2": "Suite 625",
            "address_purpose": "LOCATION",
            "city": "Broomall",
            "state": "PA",
            "postal_code": "190083512",
            "country_code": "US",
            "telephone_number": "484-421-1669",
            "fax_number": "484-565-8556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "NICOLE",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA003101L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1625 Oregon Pike",
            "city": "Lancaster",
            "state": "PA",
            "country_code": "US",
            "postal_code": "176014335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.