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

Nicole Ellison

Individual provider Physician Assistant · NPI 1679224406

Nicole Ellison is a Physician Assistant in Rochester, New York. Qualified in 2023, 3 years ago. Practices with Internal Medicine Group, a 166-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
3
Licensed in
NY
In the registry since
2022
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Practice location Address checks out

601 Elmwood Ave
Rochester, NY 14642-0001
Phone: (585) 275-4912
Fax: (585) 276-2144
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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 030084 (NY)

Record details

NPI number1679224406
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 13, 2022
Last updated in NPPESJuly 13, 2023
Certification dateJuly 13, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Internal Medicine Group — 166 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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