Individual provider Active NPI

Nicole Marie Hollek, PAC

  • Physician Assistant
  • Long Beach, CA
National Provider Identifier
1881355907
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1045 Atlantic Ave Ste 1019
Long Beach, CA 90813-3413
Phone
(562) 901-9228
NPI assigned
Jan 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 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 Primary

Addresses

Primary practice location

1045 Atlantic Ave Ste 1019
Long Beach, CA 90813-3413

Mailing address

1045 Atlantic Ave Ste 1019
Long Beach, CA 90813-3413
Phone (562) 901-9228

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
I20221024002587 CA Practitioner - Physician Assistant 1153797675 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Partners, a Medical GroupGroup PAC ID 2769388412, 236 clinicians

Practice addresses (Care Compare)

1045 Atlantic Ave
Suite 1019
Long Beach, CA 90813-3413
Phone (562) 437-6213

1760 Termino Ave
Suite 300
Long Beach, CA 90804-2157
Phone (562) 961-9991

1777 N Bellflower Blvd
Suite 210
Long Beach, CA 90815-4020
Phone (562) 719-2045

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners, a Medical Group, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Prohealth Partners, a Medical Group, Inc. CurrentSince Jul 1, 2023 Accepting new patients

Locations

1045 Atlantic Ave
Ste 1019
Long Beach, CA 90813
Phone (562) 437-6213

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1641081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1881355907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 ATLANTIC AVE STE 1019",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133413",
            "telephone_number": "562-901-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 ATLANTIC AVE STE 1019",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133413",
            "telephone_number": "562-901-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLEK",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-02",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.