NICOLE MASANKO
NPI 1699669069
Student in an Organized Health Care Education/Training Program in Tallahassee, FL

Q: What is Nicole Masanko's NPI number?

The NPI number for Nicole Masanko is 1699669069. It was assigned to this individual provider in the NPPES registry on June 9, 2025.

Q: What is Nicole Masanko's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Masanko was last updated on June 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since June 09, 2025PECOS Enrolled

1115 W CALL ST, TALLAHASSEE, FL 32304(850) 644-1855 Get Directions Write a Review

NPPES record last updated: June 9, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Nicole Masanko NPPES

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

NICOLE MASANKO (NPI 1699669069) is an individual student in an organized health care education/training program in Tallahassee, Florida and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS and is a graduate of Florida State University College Of Medicine (2025).

NPPES Registry Identity

NPI1699669069

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameNICOLE MASANKO

Location Address1115 W CALL STTallahassee, FL 32304-3556

Mailing Address1115 W Call StTallahassee, FL 32304-3556

Phone(850) 644-1855

Sole ProprietorNo

Medical School CMSFlorida State University College Of MedicineGraduated 2025

Enumeration DateJune 9, 2025

NPPES CertifiedJune 8, 2025

✔ NPI 1699669069 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1115 W CALL ST, Tallahassee, FL 32304

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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)

Nicole Masanko is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5294216495

PECOS Enrollment IDI20260225003457

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.

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.

KATHRYN BOYLAN PA-C

Physician Assistant