NICOLE THOMAS (PA-C) – Physician Assistant, NPI 1104667393

NICOLE THOMAS (PA-C) is a healthcare provider. based in Havertown, Pennsylvania. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. MA065449 (PA). The NPI Number for NICOLE THOMAS (PA-C) is 1104667393

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE THOMAS (PA-C)
NPI
1104667393
Phone
(610) 446-6900
Address
301 W CHESTER PIKE STE 101
Enumeration Date
3 June 2024
Last Update Date
19 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6104466900230
Graduation Year
2023 (3 years ago)
PAC ID
7113462409
Group Practice PAC ID
7416963988
Professional Enrollment ID
I20240710005265
Address ID
PA190834530HA301XXPIKE401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

9,689 PHYSICIAN ASSISTANT in PA

Provider Addresses for NICOLE THOMAS (PA-C)

  • 301 W CHESTER PIKE STE 101

    HAVERTOWN, PA 190834530

    Phone: (610) 446-6900

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $14.

Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.

Last reported payment date: 2024-11-21 • Largest payer in this snapshot: Optinose US, Inc. ($14).

Total Amount

$14

General + Research + Ownership

Payments

1

Total payment records

General Amount

$14

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-21

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Optinose US, Inc.$14
View all Open Payments →|Open Payments Risk Radar →

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: 2024-07-10

PECOS data refreshed: 2026-05-27

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240710005265IPhysician AssistantPATBD

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.

Verify on CMS Revalidation Lookup Tool

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 19083)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416963988View full group profile
NameSpecialtyState
-PA
Qualified AudiologistPA
Qualified AudiologistPA
Qualified Speech Language PathologistPA
Qualified AudiologistPA
Qualified AudiologistPA
Qualified Speech Language PathologistPA
-NJ
O T O L A R Y N G O L O G YPA
O T O L A R Y N G O L O G YPA

Reviews

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Frequently asked questions

Can I cross-check NICOLE THOMAS (PA-C) using NPI 1104667393?
NPI 1104667393 belongs to NICOLE THOMAS (PA-C); compare other details if you need extra assurance.
Would NICOLE THOMAS (PA-C) appear as active to a payer?
You can treat NICOLE THOMAS (PA-C) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe NICOLE THOMAS (PA-C)'s focus?
For NICOLE THOMAS (PA-C), the primary taxonomy reads as Physician Assistant. Clinical services aligned with this taxonomy classification.
What practice footprint exists for NICOLE THOMAS (PA-C)?
Travel planning: use Havertown, Pennsylvania as the reference point for NICOLE THOMAS (PA-C), then confirm.
Does NICOLE THOMAS (PA-C) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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