DR. NICOLE R AGOSTINELLI M.D.
NPI 1124280391
General Practice in San Diego, CA

Q: What is Nicole Agostinelli's NPI number?

The NPI number for Nicole Agostinelli is 1124280391. It was assigned to this individual provider in the NPPES registry on June 30, 2008.

Q: What is Nicole Agostinelli's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since June 30, 2008PECOS Enrolled

200 W ARBOR DR, SAN DIEGO, CA 92103(619) 543-6222 Get Directions Write a Review

NPPES record last updated: January 8, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 8, 2026, Jun 29, 2018, Mar 31, 2016 (3 updates tracked since 2016).

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About Dr. Nicole R Agostinelli M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NICOLE R AGOSTINELLI M.D. (NPI 1124280391) is an individual general practice provider in San Diego, California, licensed in Pennsylvania (MD443518) and active in the NPI registry since June 2008. She is enrolled in Medicare PECOS, maintains a secondary practice location in Brooklyn, and is a graduate of Howard University College Of Medicine (2006).

NPPES Registry Identity

NPI1124280391

Entity TypeIndividualFemale

Primary Taxonomy208D00000X

Provider Legal NameDR. NICOLE R AGOSTINELLICredential: M.D.

Location Address200 W ARBOR DRSan Diego, CA 92103

Mailing AddressPo Box 232410San Diego, CA 92193-2410

Phone(619) 543-6222

Sole ProprietorNo

Medical School CMSHoward University College Of MedicineGraduated 2006

Enumeration DateJune 30, 2008

Last NPPES UpdateJanuary 8, 20263 updates tracked since enumeration

NPPES CertifiedJanuary 8, 2026

✔ NPI 1124280391 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in PA · MD443518

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedEmergency MedicineTaxonomy 207P00000X · License 260276 (NY), C156148 (CA), 443518 (PA)

200 W ARBOR DR, San Diego, CA 92103

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Secondary Practice Location 1

Location 1506 6th StBrooklyn, NY 11215-3609 · Phone (718) 780-5040 · Fax (718) 780-3153

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Kansas, Inc., Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nicole R Agostinelli M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1759551203

PECOS Enrollment IDI20110819000291

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RAMIN MOTARJEMI M.D.

Internal Medicine (Geriatric Medicine)