Individual provider Active NPI

Nicholas Noschese, PA-C

  • Physician Assistant
  • Roseville, CA
National Provider Identifier
1821628553
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1013 Galleria Blvd Ste 205
Roseville, CA 95678-1363
Phone
(916) 918-2952
NPI assigned
Jan 22, 2020
Last updated
Jan 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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 NU Primary

Addresses

Primary practice location

1013 Galleria Blvd Ste 205
Roseville, CA 95678-1363

Mailing address

700 Gibson Dr Apt 312
Roseville, CA 95678-5756

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200226000612 CA Practitioner - Physician Assistant 2567899909 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Assistant Surgical Assist IncGroup PAC ID 8123271749, 35 clinicians

Practice addresses (Care Compare)

1651 Creekside Dr
Suite 100
Folsom, CA 95630-3833
Phone (916) 673-1990

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57747CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Primary Care of California PC PastSince May 1, 2023 Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1821628553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 GIBSON DR APT 312",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956785756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 GALLERIA BLVD STE 205",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956781363",
            "telephone_number": "916-918-2952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOSCHESE",
        "first_name": "NICHOLAS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-22",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.