Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Carissa Marie Kicinski, PA-C

Individual provider Physician Assistant · NPI 1992240741

Carissa Marie Kicinski, PA-C is a Physician Assistant in Raleigh, North Carolina. Qualified in 2016, 10 years ago. Practices with Carter Clinic, P A, a 13-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
10
Licensed in
NC
In the registry since
2017
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4009 Barrett Dr Ste 100
Raleigh, NC 27609-6616
Phone: (919) 848-0132
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2503 Forest Hills Rd W, Wilson, NC 27893-3300 — (252) 991-0555

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-06929 (NC)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1992240741
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 4, 2017
Last updated in NPPESOctober 12, 2020
Certification dateOctober 12, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Carter Clinic, P A — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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