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

Nicholas Anzideo, PA

Individual provider Medical Physician Assistant · NPI 1629441696

Nicholas Anzideo, PA is a Physician Assistant in North Wales, Pennsylvania. Qualified in 2015, 11 years ago. Practices with Advanced Dermatology of Pennsylvania, PC, a 28-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in New Jersey and Pennsylvania.

Years since qualifying
11
Licensed in
NJ, PA
In the registry since
2015
Specialties on file
4
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

1010 Horsham Rd Ste 201
North Wales, PA 19454-1500
Phone: (215) 362-2385
Fax: (215) 361-1584
Show map & directions

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

Additional practice locations (3)

  • 409 Route 70 E, Cherry Hill, NJ 08034-2413 — (609) 926-8899
  • 2099 New Albany Rd, Cinnaminson, NJ 08077-3534 — (609) 926-8899
  • 2418 E York St, Philadelphia, PA 19125-3006 — (609) 926-8899

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Medical Physician Assistant Taxonomy 363AM0700X · Licence 25MP00518300 (NJ)
Medical Physician Assistant Taxonomy 363AM0700X · Licence MA058011 (PA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence OA003706 (PA)

Record details

NPI number1629441696
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedNovember 12, 2015
Last updated in NPPESApril 14, 2025
Certification dateApril 14, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Advanced Dermatology Of Pennsylvania, Pc — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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