Nicole Marie Farwell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA18690 Issued in CA

Practice address

13052 Newport Ave
Tustin, CA 92780-3535

Phone

(888) 227-3312

NPI assigned

Apr 4, 2007

Last updated

Jul 20, 2024By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, VA, DC, MD4 enrollments

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 4

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nfarwell985381@direct.sentara.net

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.

• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270
  Medicare reassignment Care Compare group NPD
• Medstar Urgent Care LLC

  dba MedStar PromptCare

  • Urgent Care Clinic/Center
  • Baltimore, MD
  • NPI 1902175870
  Medicare reassignment NPD
• Providence Facey Medical Foundation

  dba Facey Medical Group

  • Internal Medicine Physician
  • Valencia, CA
  • NPI 1710031588
  Medicare reassignment
• Medstar Urgent Care, LLC

  dba MedStar PromptCare-Wheaton

  • Urgent Care Clinic/Center
  • Wheaton, MD
  • NPI 1871843409

  DC

  Medicare reassignment
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  VA

  Medicare reassignment
• Providence Facey Medical Foundation

  dba Providence Express Care

  • Multi-Specialty Clinic/Center
  • Irvine, CA
  • NPI 1891348447
  NPD
• Medstar Urgent Care LLC

  • General Practice Physician
  • Lexington Park, MD
  • NPI 1275410474
  NPD
• Medstar Urgent Care LLC

  dba MMG Urgent Care

  • Urgent Care Clinic/Center
  • Baltimore, MD
  • NPI 1942623319
  NPD
• Geller Medical Corporation

  dba United Physicians Group

  • Physical Medicine & Rehabilitation Physician
  • San Diego, CA
  • NPI 1639258239

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721433600000",
    "number": "1982726378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13052 NEWPORT AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803535",
            "telephone_number": "888-227-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13052 NEWPORT AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803535",
            "telephone_number": "888-227-3312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Sentara Park # 3",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234645884",
            "country_code": "US",
            "telephone_number": "757-252-3050",
            "fax_number": "757-222-3106",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "686 Mowry Ave",
            "address_2": "Suite 1",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "CA",
            "postal_code": "945364113",
            "country_code": "US",
            "telephone_number": "510-818-2013",
            "fax_number": "510-743-0720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARWELL",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2024-07-20",
        "certification_date": "2024-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA18690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nfarwell1586923@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "13052 Newport Ave",
            "city": "Tustin",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927803535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Cheryl Ann Farole-Roman, PSY.D., MFT
• Farshad Seyedein DDS Inc
• Farzin Sean Farshidi, DDS MD
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• Alexandra M Fauni
• Austin Faux
• Faye Hazrati DDS Inc (Dr haz dental)
• Neveen Fayed

• Physician Assistant in Tustin, CA
• Providers in Tustin, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2024; 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.