Nicole Elizabeth Conway, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9109077 Issued in FL

Practice address

11011 Sheridan St
Suite 302
Hollywood, FL 33026-1505

Phone

(954) 437-1500

NPI assigned

Oct 30, 2015

Last updated

May 31, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Orange Care Physician Partners of Florida, LLC

  dba Orange Care Medical Group LLC

  • Internal Medicine Physician
  • Hollywood, FL
  • NPI 1497355887
  Medicare reassignment
• Express Docs, LLC

  • Urgent Care Clinic/Center
  • Delray Beach, FL
  • NPI 1518309434
  NPD (past)

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1992177844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11011 SHERIDAN ST",
            "address_2": "SUITE 302",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330261505",
            "telephone_number": "954-437-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11011 SHERIDAN ST",
            "address_2": "SUITE 302",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330261505",
            "telephone_number": "954-437-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-30",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Continuum Medical PLLC (Tristate Spine and Sports Surgery)
• Yusney Contrera Fernandez
• Yamel Contrera Garcia
• Angelica Marie Contreras
• Control Behavior LLC
• Cook Community Health Agency Inc
• Katelyn Leigh Cook, PT
• Scott Cook
• Coolidge Palms Assisted Living Resort
• Coolidge Palms Assisted Living Resort, Inc (Coolidge Palms Assisted Living Resort)

• Physician Assistant in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; 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.