Mrs Nicole Carrillo, PA-C in Jersey City, NJ - Medicare Physician Assistant

Mrs Nicole Carrillo, PA-C is a medicare enrolled "Physician Assistant - Medical" in Jersey City, New Jersey. Her current practice location is 377 Jersey Ave Ste 450, Jersey City, New Jersey. You can reach out to her office (for appointments etc.) via phone at (201) 915-2525.

Mrs Nicole Carrillo is licensed to practice in New Jersey (license number 25MP00203400) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1063660983.

Contact Information

	Mrs Nicole Carrillo, PA-C
	377 Jersey Ave Ste 450, Jersey City, NJ 07302-4397
	(201) 915-2525
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Nicole Carrillo
Gender	Female
Speciality	Physician Assistant - Medical
Location	377 Jersey Ave Ste 450, Jersey City, New Jersey
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1063660983
Provider Enumeration Date: 09/04/2008
Last Update Date: 01/25/2023

Medicare PECOS Information:

PECOS PAC ID: 5991981177
Enrollment ID: I20110524000589

Medical Identifiers

Medical identifiers for Mrs Nicole Carrillo such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063660983	NPI	-	NPPES
25MP00203400	Other	NJ	LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363AM0700X	Physician Assistant - Medical	25MP00203400 (New Jersey)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Nicole Carrillo is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Nicole Carrillo, PA-C 377 Jersey Ave Ste 450, Jersey City, NJ 07302-4397 Ph: (201) 915-2525	Mrs Nicole Carrillo, PA-C 377 Jersey Ave Ste 450, Jersey City, NJ 07302-4397 Ph: (201) 915-2525

Reviews and Comments

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Mrs Nicole Carrillo, PA-C - Medicare Physician Assistant in Jersey City, NJ