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

Mrs. Nicole Marie Antenucci, PA

Individual provider Physician Assistant · NPI 1972739852

Mrs. Nicole Marie Antenucci, PA is a Physician Assistant in Tripler Army Medical Center, Hawaii. Qualified in 2005, 21 years ago. Practices with St Vincent's Ambulatory Care Inc, a 302-clinician group and accepts Medicare assignment. Licensed in Florida and Pennsylvania.

Years since qualifying
21
Licensed in
FL, PA
In the registry since
2009
Specialties on file
2
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

1 Jarrett White Rd Tamc
Tripler Army Medical Center, HI 96859-5001
Phone: (808) 433-7699
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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 PA9109691 (FL)
Medical Physician Assistant Taxonomy 363AM0700X · Licence MA052460 (PA)

Record details

NPI number1972739852
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 4, 2009
Last updated in NPPESJanuary 6, 2022
Certification dateJanuary 6, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice St Vincent'S Ambulatory Care Inc — 302 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Tripler Army Medical Center