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

Mr. Marc Nicoloff, PA-C

Individual provider Physician Assistant · NPI 1619115458

Mr. Marc Nicoloff, PA-C is a Physician Assistant in Maplewood, Minnesota. Licensed in Minnesota. Registered with an NPI since 2009.

Licensed in
MN
In the registry since
2009
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

1600 Saint Johns Blvd Ste 201
Maplewood, MN 55109-1183
Phone: (651) 747-8500
Fax: (651) 747-8501
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (MN)

Record details

NPI number1619115458
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 2, 2009
Last updated in NPPESMarch 11, 2021
Certification dateMarch 11, 2021

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