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

Individual provider Physician Assistant · NPI 1942677612

Nicole Denise Conrad, PA-C is a Physician Assistant in Maitland, Florida. Qualified in 2015, 11 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Florida and New York.

Years since qualifying
11
Licensed in
FL, NY
In the registry since
2015
Specialties on file
2
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

146 Orange Pl
Maitland, FL 32751-6531
Phone: (407) 389-2020
Fax: (407) 389-2021
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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 9108943 (FL)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 018977 (NY)

Record details

NPI number1942677612
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedAugust 28, 2015
Last updated in NPPESMay 3, 2026
Certification dateMay 3, 2026

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)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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