Individual provider Active NPI

Nicole R Barakos, PA C

  • Physician Assistant
  • Chambersburg, PA
National Provider Identifier
1972563252
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA052399 Issued in PA
Practice address
120 N 7TH St Ste 101
Chambersburg, PA 17201-1795
Phone
(717) 263-1220
Fax
(717) 263-6255
NPI assigned
Mar 23, 2006
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA052399 PA Primary
Medical Physician Assistant 363AM0700X MA052399 PA

Addresses

Primary practice location

120 N 7TH St Ste 101
Chambersburg, PA 17201-1795

Mailing address

601 Memory LN Ste a
York, PA 17402-2231
Phone (717) 851-1405

Other practice location 1

455 S Washington St Ste 12
Gettysburg, PA 17325-2516
Phone (717) 339-2875

Other practice location 2

24 Antrim Commons Dr
Greencastle, PA 17225-1623
Phone (717) 263-1220

Other practice location 3

18 Deatrick Dr
Gettysburg, PA 17325-6958
Phone (717) 339-2500

Other practice location 4

46 Walnut Bottom Rd Ste 100
Shippensburg, PA 17257-8219
Phone (717) 477-2764

Other practice location 5

100 Eisenhower Dr # A
Hanover, PA 17331-5241
Phone (717) 646-4201

Other practice location 6

1000 Norland Ave # A
Chambersburg, PA 17201-4229
Phone (717) 267-6363

Other practice location 7

97 Progress Blvd
Shippensburg, PA 17257-9053
Phone (717) 263-1220

Other practice location 8

601 E Main St
Waynesboro, PA 17268-2332
Phone (717) 263-1220

Other practice location 9

1227 Baltimore St
Hanover, PA 17331-4406
Phone (717) 812-7559

Other identifiers 1

IdentifierTypeStateIssuer
103201210MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20060214000020 PA Practitioner - Physician Assistant 9931114873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

120 N 7TH St
Chambersburg, PA 17201-1795

25 Monument Rd
York, PA 17403-5073

2618 E Market St
Autumn House
York, PA 17403
Phone (717) 845-7214

601 E Main St
Waynesboro, PA 17268-2332

914 W Market St
Autumn House West
York, PA 17403
Phone (717) 845-7214

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Jul 13, 2015 Accepting new patients
Wellspan Medical Group CurrentSince Jul 13, 2015 Accepting new patients
Wellspan Medical Group Past Accepting new patients

Locations

120 N 7th St
Ste 101
Chambersburg, PA 17201
Phone (717) 749-4801

1000 Norland Ave
#A
Chambersburg, PA 17201
Phone (717) 267-6363

120 N 7th St
Chambersburg, PA 17201
Phone (717) 217-6882

18 Deatrick Dr
Gettysburg, PA 17325
Phone (717) 339-2500

455 S Washington St
Ste 12
Gettysburg, PA 17325
Phone (717) 334-1800

24 Antrim Commons Dr
Greencastle, PA 17225
Phone (717) 593-0512

1227 Baltimore St
Hanover, PA 17331
Phone (717) 646-4204

100 Eisenhower Dr
#A
Hanover, PA 17331
Phone (717) 646-4201

97 Progress Blvd
Shippensburg, PA 17257
Phone (717) 217-6800

46 Walnut Bottom Rd
#100
Shippensburg, PA 17257
Phone (717) 477-2764

501 E Main St
Waynesboro, PA 17268
Phone (717) 765-3400

601 E Main St
Waynesboro, PA 17268
Phone (717) 765-5085

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

601 Memory Ln
Ste A
York, PA 17402

Interoperability endpoints

  • Direct secure messaging: nbarakos16217@wellspan.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1972563252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN STE A",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N 7TH ST STE 101",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172011795",
            "telephone_number": "717-263-1220",
            "fax_number": "717-263-6255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 S Washington St Ste 12",
            "address_purpose": "LOCATION",
            "city": "Gettysburg",
            "state": "PA",
            "postal_code": "173252516",
            "country_code": "US",
            "telephone_number": "717-339-2875",
            "fax_number": "717-334-3921",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24 Antrim Commons Dr",
            "address_purpose": "LOCATION",
            "city": "Greencastle",
            "state": "PA",
            "postal_code": "172251623",
            "country_code": "US",
            "telephone_number": "717-263-1220",
            "fax_number": "717-263-6255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18 Deatrick Dr",
            "address_purpose": "LOCATION",
            "city": "Gettysburg",
            "state": "PA",
            "postal_code": "173256958",
            "country_code": "US",
            "telephone_number": "717-339-2500",
            "fax_number": "717-339-2502",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "46 Walnut Bottom Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Shippensburg",
            "state": "PA",
            "postal_code": "172578219",
            "country_code": "US",
            "telephone_number": "717-477-2764",
            "fax_number": "717-839-6951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Eisenhower Dr # A",
            "address_purpose": "LOCATION",
            "city": "Hanover",
            "state": "PA",
            "postal_code": "173315241",
            "country_code": "US",
            "telephone_number": "717-646-4201",
            "fax_number": "717-646-4202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Norland Ave # A",
            "address_purpose": "LOCATION",
            "city": "Chambersburg",
            "state": "PA",
            "postal_code": "172014229",
            "country_code": "US",
            "telephone_number": "717-267-6363",
            "fax_number": "717-839-6421",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "97 Progress Blvd",
            "address_purpose": "LOCATION",
            "city": "Shippensburg",
            "state": "PA",
            "postal_code": "172579053",
            "country_code": "US",
            "telephone_number": "717-263-1220",
            "fax_number": "717-263-6255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 E Main St",
            "address_purpose": "LOCATION",
            "city": "Waynesboro",
            "state": "PA",
            "postal_code": "172682332",
            "country_code": "US",
            "telephone_number": "717-263-1220",
            "fax_number": "717-263-6255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1227 Baltimore St",
            "address_purpose": "LOCATION",
            "city": "Hanover",
            "state": "PA",
            "postal_code": "173314406",
            "country_code": "US",
            "telephone_number": "717-812-7559",
            "fax_number": "717-632-2422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARAKOS",
        "first_name": "NICOLE",
        "middle_name": "R",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA052399",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA052399",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103201210",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chambersburg, PA

Sources for this page

Verify at the official NPI Registry.