Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

EMILY OLIVIA NICHOLAS PA-C
NPI 1780461814
Physician Assistant - Surgical in Grand Rapids, MI

Q: What is Emily Nicholas's NPI number?

The NPI number for Emily Nicholas is 1780461814. It was assigned to this individual provider in the NPPES registry on September 12, 2023.

Q: What is Emily Nicholas's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Emily Nicholas was last updated on October 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days 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 September 12, 2023PECOS EnrolledAccepts Medicare Assignment

221 MICHIGAN ST NE STE 300, GRAND RAPIDS, MI 49503(616) 459-7258 Get Directions Write a Review

NPPES record last updated: October 5, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Emily Olivia Nicholas Pa-c NPPES

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

EMILY OLIVIA NICHOLAS PA-C (NPI 1780461814) is an individual surgical provider in Grand Rapids, Michigan, licensed in Michigan (5601012048) and active in the NPI registry since September 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1780461814

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameEMILY OLIVIA NICHOLASCredential: PA-C

Location Address221 MICHIGAN ST NE STE 300Grand Rapids, MI 49503-2537

Mailing Address100 Michigan St Ne # Mc845Grand Rapids, MI 49503-2560

Phone(616) 459-7258

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateSeptember 12, 2023

Last NPPES UpdateOctober 5, 2026

NPPES CertifiedOctober 5, 2026

✔ NPI 1780461814 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 MI · 5601012048

221 MICHIGAN ST NE STE 300, Grand Rapids, MI 49503

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Priority Health.Insurance ›

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

Emily Olivia Nicholas 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 ID8123472875

PECOS Enrollment IDI20230928001938

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 2

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 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 services13 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

21 services16 patients

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.

BRYAN D ANDERSON PAC

Physician Assistant (Surgical)