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

Nicole Ann Dietzel, PA-C

Individual provider Surgical Physician Assistant · NPI 1053954222

Nicole Ann Dietzel, PA-C is a Physician Assistant in Hartford, Connecticut. Qualified in 2019, 7 years ago. Practices with Connecticut Children's Specialty Group, Inc, a 144-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
7
Licensed in
CT
In the registry since
2019
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

282 Washington St
Hartford, CT 06106-3322
Phone: (860) 545-9000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 4636 (CT)

Record details

NPI number1053954222
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 21, 2019
Last updated in NPPESSeptember 12, 2022
Certification dateSeptember 12, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Connecticut Children'S Specialty Group, Inc — 144 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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