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

Individual provider Physician Assistant · NPI 1043550775

Nicole Alley Hastaba, PA-C is a Physician Assistant in Palm Beach Gardens, Florida. Qualified in 2012, 14 years ago. Practices with Shapiro and Borenstein Dermatology LLP, a 9-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
14
Licensed in
FL
In the registry since
2013
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

11030 Rca Center Dr Ste 3015
Palm Beach Gardens, FL 33410-4276
Phone: (561) 776-7041
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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 PA9107111 (FL)

Record details

NPI number1043550775
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 16, 2013
Last updated in NPPESFebruary 26, 2015

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Shapiro And Borenstein Dermatology Llp — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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