Nicole Marie Palumbo, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

64785 Issued in CA

Practice address

12370 Hesperia Rd Ste 17
Victorville, CA 92395-5808

Phone

(760) 388-0071

NPI assigned

Oct 4, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Nicole Marie Goodbread Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital of the Monterey Peninsula Hospital, Monterey, CA, CCN 050145

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Monterey Bay Oncology a Medical Corporation

  • Hematology & Oncology Physician
  • Monterey, CA
  • NPI 1972542959
  Medicare reassignment NPD
• The Oncology Institute Ca, a Professional Corporation

  • Hematology & Oncology Physician
  • Downey, CA
  • NPI 1275651515
  Medicare reassignment NPD
• Starling Oncology Ca, a Professional Corporation

  • Hematology & Oncology Physician
  • Las Vegas, NV
  • NPI 1225514508
  NPD
• Monterey Bay Oncology

  • Medical Oncology Physician
  • Monterey, CA
  • NPI 1205007408
  NPD (past)

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

• Community Hospital of the Monterey Peninsula

  • Psychiatric Hospital Unit
  • Monterey, CA
  • NPI 1679562169
  Care Compare affiliation
• Community Hospital of the Monterey Peninsula

  • General Acute Care Hospital
  • Monterey, CA
  • NPI 1932197258
  Care Compare affiliation

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

{
    "created_epoch": "1412380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1972906998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18000 STUDEBAKER RD STE 800",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032671",
            "telephone_number": "562-735-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12370 HESPERIA RD STE 17",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955808",
            "telephone_number": "760-388-0071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "399 E Highland Ave Ste 501",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924043879",
            "country_code": "US",
            "telephone_number": "909-982-4252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALUMBO",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-04",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9108180",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "64785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "GOODBREAD",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Medical Physician Assistant in Victorville, CA
• Providers in Victorville, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.