Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Heather Nickerson, MSPA-C

Individual provider Surgical Physician Assistant · NPI 1669889481

Heather Nickerson, MSPA-C is a Physician Assistant in New London, Connecticut. Qualified in 2014, 12 years ago. Practices with Elliot Professional Services, a 424-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
12
Licensed in
CT
In the registry since
2014
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Practice location Address checks out

365 Montauk Ave
New London, CT 06320-4700
Phone: (508) 560-0011
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 3135 (CT)

Record details

NPI number1669889481
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSPA-C
Sole proprietorYes
NPI enumeratedJuly 14, 2014
Last updated in NPPESJuly 14, 2014

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Elliot Professional Services — 424 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations10 on file with Medicare

Other providers in New London