Individual provider Active NPI

Nicole Lynn McQuillan, PA-C

  • Medical Physician Assistant
  • Harrisburg, PA
National Provider Identifier
1942967294
Registry record updated Nov 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
063183 Issued in PA
Practice address
111 S Front St
Harrisburg, PA 17101-2010
Phone
(717) 988-0000
Fax
(717) 782-5716
NPI assigned
Nov 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 063183 PA Primary
Medical Physician Assistant 363AM0700X 005930 PA

Addresses

Primary practice location

111 S Front St
Harrisburg, PA 17101-2010

Mailing address

604 Stoney Run Rd
Pottsville, PA 17901-8729
Phone (570) 933-0890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MT2 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
I20220308000035 PA Practitioner - Physician Assistant 4981098985 Reassigns benefits to 1 organization
I20251023003717 MT Practitioner - Physician Assistant 4981098985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lewis and Clark Emergency Physicians P CGroup PAC ID 0941196497, 8 clinicians

Practice addresses (Care Compare)

2475 E Broadway St
Helena, MT 59601-4928
Phone (406) 442-2480

Hospital & facility affiliations

  • St Peters Health Hospital, Helena, MT, CCN 270003

Merit-based Incentive Payment System (MIPS)

Final score
93.46 of 100Reported as group
Quality
92.17
Promoting interoperability
100
Improvement activities
40
Cost
78.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005930PAMDMedical Physician Assistant
063183PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis and Clark Emergency Physicians P C CurrentSince Sep 1, 2025 Accepting new patients

Locations

2475 E Broadway St
Helena, MT 59601
Phone (406) 442-2480

Interoperability endpoints

  • Direct secure messaging: nmcquillan296306@upmc.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637884800000",
    "number": "1942967294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 STONEY RUN RD",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179018729",
            "telephone_number": "570-933-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S FRONT ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171012010",
            "telephone_number": "717-988-0000",
            "fax_number": "717-782-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCQUILLAN",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-26",
        "certification_date": "2021-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "063183",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "005930",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.