NICOLE JANETTE HAHN (PA) – Physician Assistant, NPI 1497953053
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,360 PHYSICIAN ASSISTANT in NY
Provider Addresses for NICOLE JANETTE HAHN (PA)
739 CALLE BAHIA
SAN CLEMENTE, CA 926722418
Phone:
Type: Mailing
Stony Brook University Hospital
HSC T-19 Room 060
Stony Brook, NY 117940001
Phone: (631) 444-9394
Type: Location
1, Market Path, Suffolk County, New York, 11733, United States
SETAUKET, NY 117332219
Phone: (631) 566-5310
Type: Mailing
Stony Brook University Hospital, 101, Nicolls Road, Suffolk County, New York, 11794, United States
HSC T-19 ROOM 060
STONY BROOK, NY 117940001
Phone: (631) 444-9394
Type: Location
24012 CALLE DE LA PLATA STE 200
LAGUNA HILLS, CA 926537624
Phone: (926) 914-3675
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $80.
Total Amount is formed as General ($80) + Research ($0) + Ownership ($0) = $80.
Last reported payment date: 2024-11-11 • Largest payer in this snapshot: Dermavant Sciences, Inc. ($30).
Total Amount
$80
General + Research + Ownership
Payments
4
Total payment records
General Amount
$80
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Dermavant Sciences, Inc. | $30 |
| GENZYME CORPORATION | $27 |
| Amgen Inc. | $23 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-05-07
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240507001757 | I | Physician Assistant | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 92672)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | CA | |
| General Practice | FL | |
| Nurse Practitioner | CA | |
| D E R M A T O L O G Y | CA | |
| Physician Assistant | CA | |
| D E R M A T O L O G Y | CA | |
| Physician Assistant | UT | |
| D E R M A T O L O G Y | CA | |
| Physician Assistant | CA | |
| - | CA |
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