Lillian Nicholson, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9117659 Issued in FL

Practice address

1286 Florida Ave S Ste 1
Rockledge, FL 32955-2400

Phone

(321) 636-7780

Fax

(321) 636-1152

NPI assigned

May 22, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Lillian Mann Former name

Medicare fee-for-service enrollment

Enrolled in FL

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DRS Roberts and Bryan PAGroup PAC ID 3678563251, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Freedom Health HMO Network

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.

• DRS Roberts & Bryan PA

  • Dermatology Physician
  • Rockledge, FL
  • NPI 1346226404
  Medicare reassignment Care Compare group
• Associates in Dermatology Inc

  • Specialist
  • Kissimmee, FL
  • NPI 1316960297
  Medicare reassignment

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1861184533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1286 FLORIDA AVE S STE 1",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552400",
            "telephone_number": "213-636-7780",
            "fax_number": "321-636-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1286 FLORIDA AVE S STE 1",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552400",
            "telephone_number": "321-636-7780",
            "fax_number": "321-636-1152"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2205 North Blvd W",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "FL",
            "postal_code": "338378933",
            "country_code": "US",
            "telephone_number": "800-827-7546",
            "fax_number": "863-421-0466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "LILLIAN",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9117659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LILLIAN",
            "last_name": "MANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nextgen Pathology
• Hai Nguyen, DDS
• Thomas Bao Nguyen, MD
• Trang My Nguyen, APRN
• Muhammed Wasim Niazi, MD
• Magalie Nicolas, LCSW
• Freda A Nime, MD
• Bernard Noble, MD
• Jessica Norman, RBT
• Ramon Novak

• Physician Assistant in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; 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.