Individual provider Active NPI

Regina M Nicholson, PA-C

  • Physician Assistant
  • Midlothian, TX
National Provider Identifier
1891274809
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA12185 Issued in TX
Practice address
220 US Highway 287 Ste 200
Midlothian, TX 76065-2296
Phone
(732) 463-7546
NPI assigned
Aug 9, 2018
Last updated
Oct 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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 PA12185 TX Primary

Addresses

Primary practice location

220 US Highway 287 Ste 200
Midlothian, TX 76065-2296

Mailing address

220 US Highway 287 Ste 200
Midlothian, TX 76065-2296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181011002726 NJ Practitioner - Physician Assistant 6204188642 Reassigns benefits to 2 organizations
I20210406001758 TX Practitioner - Physician Assistant 6204188642 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Rutgers New Jersey Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hopkins Dermatology ApmcGroup PAC ID 6709945272, 5 clinicians

Practice addresses (Care Compare)

321 W Southlake Blvd
180 Hopkins Dermatology Texas PLLC
Southlake, TX 76092-6287
Phone (682) 271-0988

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA12185TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Feb 1, 2021 Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Feb 1, 2021 Accepting new patients
Hopkins Dermatology Apmc Past Accepting new patients
Rutgers Health - Behavioral Health Past Accepting new patients

Locations

125 Paterson St
Ste 5100
New Brunswick, NJ 08901
Phone (732) 235-7060

125 Paterson St
Ste 6100
New Brunswick, NJ 08901
Phone (732) 235-6561

1 Worlds Fair Dr
Somerset, NJ 08873
Phone (732) 235-7775

1 Worlds Fair Dr
Ste 2400
Somerset, NJ 08873
Phone (732) 235-7993

Interoperability endpoints

  • Direct secure messaging: rnicholson@directaddress.net

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1891274809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 US HIGHWAY 287 STE 200",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760652296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 US HIGHWAY 287 STE 200",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760652296",
            "telephone_number": "732-463-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "REGINA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-09",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, TX

Sources for this page

Verify at the official NPI Registry.