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

MS. Nicole Maria Antzoulides Conroe, PA

Individual provider Medical Physician Assistant · NPI 1740422336

MS. Nicole Maria Antzoulides Conroe, PA is a Physician Assistant in Orchard Park, New York. Qualified in 2008, 18 years ago. Practices with Academic Medicine Services, Inc, a 116-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
18
Licensed in
NY
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.

See every abbreviation used in this directory →

Practice location Address checks out

3680 Eggert Rd
Orchard Park, NY 14127-1963
Phone: (716) 662-5357
Fax: (716) 662-2774
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 013201 (NY)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 013201-1 (NY)

Record details

NPI number1740422336
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMarch 30, 2009
Last updated in NPPESFebruary 8, 2021
Certification dateFebruary 8, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Academic Medicine Services, Inc. — 116 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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