Nicole Denise Conrad, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9108943 Issued in FL

Practice address

146 Orange PL
Maitland, FL 32751-6531

Phone

(407) 389-2020

Fax

(407) 389-2021

NPI assigned

Aug 28, 2015

Last updated

May 3, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Art of Dermatology PLLC

  • Dermatology Physician
  • Berkley, MI
  • NPI 1275022519

  FL

  Medicare reassignment NPD
• Dermatology Group PA

  • Specialist
  • Mount Dora, FL
  • NPI 1356300081
  NPD (past)
• Alan Bolton, MD, PC

  • Obstetrics & Gynecology Physician
  • Berkley, MI
  • NPI 1467632901
  NPD (past)

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

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777766400000",
    "number": "1942677612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S ORLANDO AVE STE 100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327895543",
            "telephone_number": "239-397-2739",
            "fax_number": "248-876-9144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 ORANGE PL",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327516531",
            "telephone_number": "407-389-2020",
            "fax_number": "407-389-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "NICOLE",
        "middle_name": "DENISE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-28",
        "last_updated": "2026-05-03",
        "certification_date": "2026-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9108943",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "018977",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krisiely Colon
• Jill Ashley Coltrin, ARNP, FNP-C
• Community Life Dev
• Compassionate Care Psychiatry LLC
• Marilyn Gray Connolly, APRN
• Caitlin Ashley Cooks
• Beverly Cooper, M.S.
• Peter Copan, MA, MS, RMHCI
• Coram Alternate Site Services, Inc. (Coram Specialty Infusion Services, an Apria Healthcare Company)
• Hattie Grace Corbin

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2026; 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.