Nicole Rose La Bombarda, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1000 Greg Kruschek Avenue
Nome, AK 99762

Phone

(907) 443-3311

NPI assigned

Mar 5, 2009

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

Enrolled in AK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: nrlabombarda@direct.nshcorp.org
• Direct secure messaging: nicole.thomaspa.p1@direct.aramd.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.

• Norton Sound Health Corporation

  • Critical Access Hospital
  • Nome, AK
  • NPI 1154358232

  Physician Assistant

  Medicare reassignment NPD
• Norton Sound Health Corporation

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Nome, AK
  • NPI 1427187046
  NPD

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

{
    "created_epoch": "1236211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1972743748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1550",
            "city": "NOME",
            "state": "AK",
            "postal_code": "997621550",
            "telephone_number": "907-443-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 GREG KRUSCHEK AVENUE",
            "city": "NOME",
            "state": "AK",
            "postal_code": "99762",
            "telephone_number": "907-443-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA BOMBARDA",
        "first_name": "NICOLE",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-05",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130061000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerry Kowchee Sr.
• Bertha Carol Koweluk
• Kendal Wagner Kruse, RD
• Sherry Kulukhon, CDC1
• Kristy Kuzuguk
• Jane Louise Lando, RPH
• Raymond Lang, DDS
• Last Frontier Eye Care
• Teresa Lynn Lawvor Miller, LMT, HHP, MMP
• Timothy Lemaire, DO

• Physician Assistant in Nome, AK
• Providers in Nome, AK by specialty
• Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.