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

Individual provider Medical Physician Assistant · NPI 1437946381

Nicole Dominique Roderos, PA-C is a Physician Assistant in Palm Springs, California. Qualified in 2024, 2 years ago. Practices with First Choice Physician Partners, a 140-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
2
Licensed in
CA
In the registry since
2025
Specialties on file
3
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

1180 N Indian Canyon Dr Ste W201
Palm Springs, CA 92262-4876
Phone: (760) 416-4575
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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 PA66480 (CA)
Medical Physician Assistant Taxonomy 363AM0700X
Surgical Physician Assistant Taxonomy 363AS0400X

Record details

NPI number1437946381
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedApril 23, 2025
Last updated in NPPESAugust 18, 2025
Certification dateAugust 18, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice First Choice Physician Partners — 140 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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