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

Individual provider Medical Physician Assistant · NPI 1104443985

Nicole Renee Driscoll, PA-C is a Physician Assistant in Manhasset, New York. Qualified in 2020, 6 years ago. Practices with Stony Brook Internists University Faculty Practice Corporation, a 428-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
6
Licensed in
NY
In the registry since
2020
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

300 Community Dr
Manhasset, NY 11030-3816
Phone: (516) 526-8400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 025171 (NY)

Record details

NPI number1104443985
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 29, 2020
Last updated in NPPESMarch 9, 2022
Certification dateMarch 9, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Stony Brook Internists University Faculty Practice Corporation — 428 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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