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

Nicole Kaczor

Individual provider Physician Assistant · NPI 1528674934

Nicole Kaczor is a Physician Assistant in Lebanon, New Hampshire. Qualified in 2021, 5 years ago. Practices with St Josephs Medical PC, a 385-clinician group and accepts Medicare assignment. Licensed in New Hampshire.

Years since qualifying
5
Licensed in
NH
In the registry since
2020
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Practice location Address checks out

1 Medical Center Dr
Lebanon, NH 03756-1000
Phone: (603) 650-5000
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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 EL09804 (NH)

Record details

NPI number1528674934
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 21, 2020
Last updated in NPPESJuly 29, 2022
Certification dateJuly 29, 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)
Group practice St Josephs Medical Pc — 385 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Lebanon