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JACQUELINE CHANTAL NICOLICH RPA-C
NPI 1346780046
Physician Assistant - Surgical in Southampton, NY

Active since February 28, 2017PECOS EnrolledAccepts Medicare Assignment
98.52/100
CMS Quality Rating
MEETING HOUSE LANE MEDICAL PRACTICE, PC SURGICAL SPEC., 240, SOUTHAMPTON, NY 11968(631) 726-8717(631) 726-8720 Get Directions Write a Review

NPPES record last updated: April 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 18, 2018, Feb 28, 2017 (2 updates tracked since 2017).

About Jacqueline Chantal Nicolich Rpa-c NPPES

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

JACQUELINE CHANTAL NICOLICH RPA-C (NPI 1346780046) is an individual surgical provider in Southampton, New York, licensed in New York (020637) and active in the NPI registry since February 2017. She is enrolled in Medicare PECOS, is affiliated with Suny/stony Brook University Hospital, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1346780046
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameJACQUELINE CHANTAL NICOLICHCredential: RPA-C
Location AddressMEETING HOUSE LANE MEDICAL PRACTICE, PC SURGICAL SPEC., 240Southampton, NY 11968
Mailing Address4 Springville Rd Ste BHampton Bays, NY 11946-2290 · (631) 726-8717 · Fax (631) 726-8720
Phone(631) 726-8717
Fax(631) 726-8720
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateFebruary 28, 2017
Last NPPES UpdateApril 21, 20252 updates tracked since enumeration
NPPES CertifiedApril 21, 2025
✔ NPI 1346780046 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in NY · 020637
MEETING HOUSE LANE MEDICAL PRACTICE, PC SURGICAL SPEC., Southampton, NY 11968
Open in Google Maps ↗

Other Names 1

Former Name (1)Jacqueline Chantal Rosante Rpa-c

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacqueline Chantal Nicolich Rpa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4082990205
PECOS Enrollment IDI20170424000906
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.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
87 services46 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
66 services31 patients
Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose J7324
Orthovisc is a treatment involving injections of a substance called hyaluronan into your joints. Hyaluronan is a natural substance in your joint fluid that aids in movement and reduces pain. The Orthovisc injections help replenish this substance, relieving joint pain.
49 services14 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
32 services32 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
29 services27 patients
X-ray of knee, 3 views 73562
An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.
17 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Suny/Stony Brook University Hospital

Acute Care Hospitals · Stony Brook, NY
4/5 CMS rating
OwnershipGovernment - State
CMS Certification Number330393
LocationHealth Sciences Center SunyStony Brook, NY 11794 · Suffolk County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

98.52/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality82.85
Promoting Interoperability100
Improvement Activities40

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacqueline Nicolich's NPI number?

The NPI number for Jacqueline Nicolich is 1346780046. It was assigned to this individual provider in the NPPES registry on February 28, 2017. The provider is also known as Jacqueline Chantal Rosante Rpa-C.

Where is Jacqueline Nicolich located?

Jacqueline Nicolich practices at Meeting House Lane Medical Practice, PC Surgical Spec. 240, Southampton, NY 11968. The listed phone number is (631) 726-8717.

What is Jacqueline Nicolich's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Jacqueline Nicolich enrolled in Medicare?

Yes. Jacqueline Nicolich is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Jacqueline Nicolich affiliated with any hospitals?

According to CMS data, Jacqueline Nicolich is affiliated with Suny/Stony Brook University Hospital.

When was this NPI record last updated?

The NPPES record for Jacqueline Nicolich was last updated on April 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.