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

Individual provider Physician Assistant · NPI 1497389621

Miss. Nicolette Larosa, PA-C is a Physician Assistant in Philadelphia, Pennsylvania. Qualified in 2019, 7 years ago. Practices with Cooper University Radiology PC, a 68-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in New Jersey and Pennsylvania.

Years since qualifying
7
Licensed in
NJ, PA
In the registry since
2020
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

3400 Spruce Street 3 Ravdin Bldg Ste F
Philadelphia, PA 19104-4206
Phone: (215) 662-3202
Fax: (215) 349-8432
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1 Cooper Plz, Camden, NJ 08103-1461 — (888) 499-8779

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MA062445 (PA)
Physician Assistant Taxonomy 363A00000X · Licence 25MP00670900 (NJ)

Record details

NPI number1497389621
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 26, 2020
Last updated in NPPESApril 29, 2025
Certification dateApril 29, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Cooper University Radiology Pc — 68 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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