NPIMap

Individual provider Active NPI

Nicole Marie Larson, P.A.-C

  • Medical Physician Assistant
  • Latrobe, PA
National Provider Identifier
1952422586
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA053443 Issued in PA
Practice address
1 Mellon Way
Latrobe, PA 15650-1197
Phone
(724) 689-0520
Fax
(724) 689-0522
NPI assigned
Apr 2, 2007
Last updated
Sep 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA053443 PA Primary

Addresses

Primary practice location

1 Mellon Way
Latrobe, PA 15650-1197

Mailing address

1 Mellon Way
Latrobe, PA 15650-1197
Phone (724) 689-0520

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nicolelarson@emg.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081029000813 PA Practitioner - Physician Assistant 9638238025 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Pittsburgh PhysiciansGroup PAC ID 8729990239, 4,166 clinicians

Practice addresses (Care Compare)

2775 Mosside Blvd
Monroeville, PA 15146-2760
Phone (412) 357-3161

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA053443PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince Jul 7, 2008 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jul 7, 2008 Accepting new patients
Indiana Healthcare Physician Services, Inc CurrentSince Dec 1, 2022 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

640 Kolter Dr
Indiana, PA 15701
Phone (724) 357-7196

300 Halket St
Ste 5200
Pittsburgh, PA 15213
Phone (412) 641-7850

Organizations & group practices 6

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.

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1952422586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MELLON WAY",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156501197",
            "telephone_number": "724-689-0520",
            "fax_number": "724-689-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MELLON WAY",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156501197",
            "telephone_number": "724-689-0520",
            "fax_number": "724-689-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA053443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicolelarson@emg.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1 Mellon Way",
            "city": "Latrobe",
            "state": "PA",
            "country_code": "US",
            "postal_code": "156501197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Latrobe, PA

Sources for this page

Verify at the official NPI Registry.