Michelle Diane Nicely, P.A.- C.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9100658 Issued in FL

Practice address

3301 W Gandy Blvd
Tampa, FL 33611-2931

Phone

(813) 925-1903

Fax

(813) 749-8370

NPI assigned

Dec 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: michelle.nicely.2@31614.direct.athenahealth.com
• Direct secure messaging: michelle.nicely.p1@direct.crossroadmc.nextgenshare.com

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.

• Raypar Inc

  • Family Medicine Physician
  • Winter Haven, FL
  • NPI 1356374466
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1972662922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5618 OSPREY PARK PL",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335473814",
            "telephone_number": "813-684-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 W GANDY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336112931",
            "telephone_number": "813-925-1903",
            "fax_number": "813-749-8370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 NE 6th Ave",
            "address_purpose": "LOCATION",
            "city": "Estacada",
            "state": "OR",
            "postal_code": "970239312",
            "country_code": "US",
            "telephone_number": "971-373-4165",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24461 E Welches Rd",
            "address_purpose": "LOCATION",
            "city": "Welches",
            "state": "OR",
            "postal_code": "970677067",
            "country_code": "US",
            "telephone_number": "971-373-4165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICELY",
        "first_name": "MICHELLE",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "P.A.- C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9100658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000564500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yong Mei Ni, MD
• Pontea Niaki, MD
• Nancy Carolina Nicaragua- Ferrante, M.ED., BCBA
• Lindsay Michelle Niccolai, PHD
• Chris Nicely
• Nicholas Koehler, P.a.
• Nicholas Mickelson LLC
• Dion Albert Nicholas, LMT
• Melissa Michelle Nicholas
• Michael John Nicholas, MD

• Medical Physician Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.