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

Nicholas Ivar Cookson, PA-C

Individual provider Physician Assistant · NPI 1104318427

Nicholas Ivar Cookson, PA-C is a Physician Assistant in Worcester, Massachusetts. Qualified in 2018, 8 years ago. Practices with Umass Memorial Medical Group Inc, a 2,467-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Massachusetts and Rhode Island.

Years since qualifying
8
Licensed in
MA, RI
In the registry since
2018
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

55 Lake Ave N
Worcester, MA 01655-0002
Phone: (508) 334-7828
Fax: (508) 334-7284
Show map & directions

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

Additional practice locations (2)

  • 593 Eddy St, Providence, RI 02903-4923 — (401) 444-7585
  • 127 Prospect St, Warwick, RI 02886-7138 — (401) 595-7832

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA101610 (MA)
Physician Assistant Taxonomy 363A00000X · Licence PA01048 (RI)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1104318427
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 1, 2018
Last updated in NPPESOctober 9, 2025
Certification dateOctober 9, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Umass Memorial Medical Group Inc — 2467 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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