Individual provider Active NPI

Nicole Takako Hitomi, PA-C

  • Physician Assistant
  • Riverside, CA
National Provider Identifier
1841174992
Registry record updated Aug 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA66448 Issued in CA
Practice address
3770 Elizabeth St
Riverside, CA 92506-2527
Phone
(951) 352-3937
Fax
(951) 352-2839
NPI assigned
Aug 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2025

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 PA66448 CA Primary

Addresses

Primary practice location

3770 Elizabeth St
Riverside, CA 92506-2527

Mailing address

741 Ygnacio Woods CT
Concord, CA 94518-2203
Phone (925) 818-0064

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
I20251106002922 CA Practitioner - Physician Assistant 5496245623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiology Specialists Medical Group IncGroup PAC ID 9830164359, 12 clinicians

Practice addresses (Care Compare)

3770 Elizabeth St
Riverside, CA 92506-2527
Phone (951) 352-3937

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA66448CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology Specialists Medical Group, Inc. CurrentSince Oct 1, 2025 Accepting new patients

Locations

830 Magnolia Ave
Ste 101
Corona, CA 92879

3770 Elizabeth St
Riverside, CA 92506
Phone (951) 237-7331

Organizations & group practices 1

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": "1754092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754092800000",
    "number": "1841174992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 YGNACIO WOODS CT",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945182203",
            "telephone_number": "925-818-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3770 ELIZABETH ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062527",
            "telephone_number": "951-352-3937",
            "fax_number": "951-352-2839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HITOMI",
        "first_name": "NICOLE",
        "middle_name": "TAKAKO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-02",
        "last_updated": "2025-08-02",
        "certification_date": "2025-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA66448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.