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

Miss. Ivy Lane Ziccarelli, PA-C

Individual provider Medical Physician Assistant · NPI 1629434691

Miss. Ivy Lane Ziccarelli, PA-C is a Physician Assistant in Matthews, North Carolina. Qualified in 2015, 11 years ago. Practices with Novant Health Medical Group, LLC, a 2,410-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
11
Licensed in
NC
In the registry since
2016
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

1401 Matthews Township Pkwy Ste 320
Matthews, NC 28105
Phone: (704) 384-1261
Fax: (704) 384-3145
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • Novant Health Psychiatric Associates, Matthews, NC 28105-5403 — (704) 384-1261
  • 10801 Monroe Rd, Matthews, NC 28105-8335 — (704) 237-4240

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-06261 (NC)
Medical Physician Assistant Taxonomy 363AM0700X (NC)

Record details

NPI number1629434691
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 6, 2016
Last updated in NPPESOctober 26, 2020
Certification dateSeptember 6, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Novant Health Medical Group, Llc — 2410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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