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

Individual provider Physician Assistant · NPI 1104448489

Mr. Nicholas Ruggiero, PA-C is a Physician Assistant in Staten Island, New York. Qualified in 2020, 6 years ago. Practices with True North Medical Group PC, a 186-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
6
Licensed in
NY
In the registry since
2020
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

136 Brook Ave
Staten Island, NY 10306-4420
Phone: (718) 619-6124
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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 025948 (NY)

Record details

NPI number1104448489
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedMay 10, 2020
Last updated in NPPESApril 8, 2021
Certification dateApril 8, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice True North Medical Group Pc — 186 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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