Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary Nickerson, PA

Individual provider Physician Assistant · NPI 1346316478

Mary Nickerson, PA is a Physician Assistant in Carmel, New York. Graduated from State University of New York at Stony Brook, School of Medicine in 1997, 29 years ago. Practices with Rego Park Counseling LLC, a 5-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
29
Trained at
State University of New York at Stony Brook, School of Medicine
Licensed in
NY
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

75 Seminary Hill Rd
Carmel, NY 10512-1921
Phone: (518) 952-8142
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 006250 (NY)

Record details

NPI number1346316478
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 28, 2006
Last updated in NPPESApril 30, 2008
Mailing addressPo Box 31094, Hartford, CT 06150-1094

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolSTATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduated 1997 (29 years in practice)
Group practice Rego Park Counseling Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Carmel