Nicole L Landis, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA059082 Issued in PA

Practice address

2580 Haymaker Rd Ste 102
Monroeville, PA 15146-3500

Phone

(412) 858-3070

NPI assigned

May 23, 2017

Last updated

Nov 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nicole L Renzi Former name

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Medical Associates PCGroup PAC ID 9830003235, 104 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Forbes Hospital Hospital, Monroeville, PA, CCN 390267

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nrenzi133235@direct.ahn.org

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.

• Premier Medical Associates PC

  • Internal Medicine Physician
  • Monroeville, PA
  • NPI 1447281092
  Medicare reassignment Care Compare group NPD
• Ahn Observation Group LLC

  • Emergency Medicine Physician
  • Jefferson Hills, PA
  • NPI 1437814696
  Medicare reassignment
• Allegheny Clinic

  dba AHN-Primary Care Bethel Park

  • Family Medicine Physician
  • Bethel Park, PA
  • NPI 1073081493
  Medicare reassignment
• Excela Health Physician Practices, Inc

  dba Excela Health Cardiology

  • Cardiovascular Disease Physician
  • Greensburg, PA
  • NPI 1821225202
  Medicare reassignment
• Allegheny Clinic

  dba AHN Primary Care Mobile Clinic

  • Primary Care Clinic/Center
  • Pittsburgh, PA
  • NPI 1215752548
  NPD
• Allegheny Clinic

  dba AHN Neurology

  • Neurology Physician
  • Pittsburgh, PA
  • NPI 1821098260
  NPD
• Excela Health Physician Practices, Inc.

  dba Excela Health Neurosurgery

  • Neurological Surgery Physician
  • Latrobe, PA
  • NPI 1083002661
  NPD
• Excela Health Physician Practices, Inc.

  dba Walk-in Clinic

  • Family Medicine Physician
  • Greensburg, PA
  • NPI 1235004193
  NPD
• Premier Medical Associates, PC

  • Clinical Medical Laboratory
  • Monroeville, PA
  • NPI 1851634752
  NPD
• Allegheny Clinic

  dba AGH Cardiology

  • Cardiovascular Disease Physician
  • Pittsburgh, PA
  • NPI 1629078332
  NPD (past)

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

• West Penn Allegheny Health System Inc.

  dba Forbes Regional Hospital

  • General Acute Care Hospital
  • Monroeville, PA
  • NPI 1679592380
  Care Compare affiliation

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1831626761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 HAYMAKER RD STE 102",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151463500",
            "telephone_number": "412-858-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 HAYMAKER RD STE 102",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151463500",
            "telephone_number": "412-858-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "NICOLE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-23",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA059082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14034537",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "RENZI",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Steffanie Labate, MD
• Margaret J Labella, RPH
• Louis Anthony Lamanna III
• David L Lambie Jr., RN
• Catherine E Land, CRNA
• Stephanie Nicole Landis, DPT
• Landmark Treatment Center
• Landmark Treatment Center
• Caroline Marie Landowski, PA-C
• Seth A Lang, DMD

• Medical Physician Assistant in Monroeville, PA
• Providers in Monroeville, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.