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NICOLE KOZLAK PA-C
NPI 1386215390
Physician Assistant - Surgical in Farmington, CT

Active since July 09, 2021PECOS EnrolledAccepts Medicare Assignment
79.34/100
CMS Quality Rating
263 FARMINGTON AVE, FARMINGTON, CT 06030(860) 679-3899(860) 676-3476 Get Directions Write a Review

NPPES record last updated: September 26, 2022. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 26, 2022, Aug 13, 2021, Jul 9, 2021 (3 updates tracked since 2021).

About Nicole Kozlak Pa-c NPPES

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

NICOLE KOZLAK PA-C (NPI 1386215390) is an individual surgical provider in Farmington, Connecticut, licensed in Connecticut (5292) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in Farmington, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1386215390
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameNICOLE KOZLAKCredential: PA-C
Location Address263 FARMINGTON AVEFarmington, CT 06030-8063
Mailing Address263 Farmington AveFarmington, CT 06030-8063 · (860) 679-3899 · Fax (860) 676-3476
Phone(860) 679-3899
Fax(860) 676-3476
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateJuly 9, 2021
Last NPPES UpdateSeptember 26, 20223 updates tracked since enumeration
NPPES CertifiedAugust 13, 2021
✔ NPI 1386215390 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 CT · 5292
263 FARMINGTON AVE, Farmington, CT 06030
Open in Google Maps ↗

Secondary Practice Location 1

Location 1263 Farmington AveFarmington, CT 06030-0001 · Phone (860) 679-2000

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

Nicole Kozlak Pa-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 ID5193120749
PECOS Enrollment IDI20210820000952
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

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.

Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
33 services31 patients

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.

79.34/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality69.22
Promoting Interoperability100
Improvement Activities40
Cost48.08

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.

STATE OF CONNECTICUT HEALTH CENTER
Pathology (Anatomic Pathology & Clinical Pathology)
263 FARMINGTON AVE, LABORATORY HBP GROUP
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-7503
MR. IAN THOMAS MCNEILL
Neurological Surgery
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-8080
DR. LUIS CHAVEZ DE PAZ DDS, MS, PHD
Dentist (Endodontics)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-2719
TARUNYA REDDY VEDERE
Internal Medicine (Endocrinology, Diabetes & Metabolism)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3245
ZACHARY TALLENT SOLOMON
Surgery
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3467
MICHAEL CONNOLLY
Psychiatry & Neurology (Psychiatry)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-4733
EMILY WENG DO
Internal Medicine (Gastroenterology)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3158
ANDREW KEMERLEY DO
Student in an Organized Health Care Education/Training Program
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3467

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 Nicole Kozlak's NPI number?

The NPI number for Nicole Kozlak is 1386215390. It was assigned to this individual provider in the NPPES registry on July 9, 2021.

Where is Nicole Kozlak located?

Nicole Kozlak practices at 263 Farmington Ave, Farmington, CT 06030. The listed phone number is (860) 679-3899.

What is Nicole Kozlak's specialty?

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

Is Nicole Kozlak enrolled in Medicare?

Yes. Nicole Kozlak 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.

When was this NPI record last updated?

The NPPES record for Nicole Kozlak was last updated on September 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.