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

Individual provider Medical Physician Assistant · NPI 1942884838

Nicole Dolores Kopchak, PA is a Physician Assistant in New York, New York. Qualified in 2021, 5 years ago. Works from 3 locations. Licensed in New York.

Years since qualifying
5
Licensed in
NY
In the registry since
2021
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

535 W 110th St Apt 1E
New York, NY 10025-2021
Phone: (212) 280-4740
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 315 W 70th St Apt 1b, New York, NY 10023-3504 — (212) 280-4740
  • 55 E 87th St Ste 1f, New York, NY 10128-1049 — (212) 280-4740

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 026978 (NY)

Record details

NPI number1942884838
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 7, 2021
Last updated in NPPESSeptember 15, 2022
Certification dateSeptember 15, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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