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

Individual provider Surgical Physician Assistant · NPI 1386215390

Nicole Kozlak, PA-C is a Physician Assistant in Farmington, Connecticut. Qualified in 2021, 5 years ago. Practices with University of Connecticut Health Center, a 628-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
5
Licensed in
CT
In the registry since
2021
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

263 Farmington Ave
Farmington, CT 06030-8063
Phone: (860) 679-3899
Fax: (860) 676-3476
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 263 Farmington Ave, Farmington, CT 06030-0001 — (860) 679-2000

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 5292 (CT)

Record details

NPI number1386215390
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 9, 2021
Last updated in NPPESSeptember 26, 2022
Certification dateAugust 13, 2021

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 University Of Connecticut Health Center — 628 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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