MISS NICOLE TESSA WIZEL PA-C
NPI 1497122170
Physician Assistant - Medical in Fresh Meadows, NY

Q: What is Nicole Wizel's NPI number?

The NPI number for Nicole Wizel is 1497122170. It was assigned to this individual provider in the NPPES registry on August 28, 2015.

Q: What is Nicole Wizel's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Wizel was last updated on August 28, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 28, 2015PECOS Enrolled

17660 UNION TPKE, SUITE 360, FRESH MEADOWS, NY 11366(718) 460-2300 Get Directions Write a Review

NPPES record last updated: August 28, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Miss Nicole Tessa Wizel Pa-c NPPES

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

MISS NICOLE TESSA WIZEL PA-C (NPI 1497122170) is an individual medical provider in Fresh Meadows, New York and active in the NPI registry since August 2015. She is enrolled in Medicare PECOS and is a graduate of Mercy College (2015).

NPPES Registry Identity

NPI1497122170

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMISS NICOLE TESSA WIZELCredential: PA-C

Location Address17660 UNION TPKE, SUITE 360Fresh Meadows, NY 11366-1526

Mailing Address17660 Union Tpke, Suite 360Fresh Meadows, NY 11366-1526 · (718) 460-2300

Phone(718) 460-2300

Sole ProprietorYes

Medical School CMSMercy CollegeGraduated 2015

Enumeration DateAugust 28, 2015

✔ NPI 1497122170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

17660 UNION TPKE, Fresh Meadows, NY 11366

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miss Nicole Tessa Wizel Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6507159118

PECOS Enrollment IDI20260514002998

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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