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JEREMY NICOLOFF PA-C
NPI 1912370305
Physician Assistant - Surgical in Burlingame, CA

Active since November 05, 2015PECOS Enrolled
1501 TROUSDALE DR FL 1, BURLINGAME, CA 94010(650) 652-8700(650) 652-8705 Get Directions Write a Review

NPPES record last updated: May 6, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jeremy Nicoloff Pa-c NPPES

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

JEREMY NICOLOFF PA-C (NPI 1912370305) is an individual surgical provider in Burlingame, California, licensed in California (PA52946) and active in the NPI registry since November 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912370305
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameJEREMY NICOLOFFCredential: PA-C
Location Address1501 TROUSDALE DR FL 1Burlingame, CA 94010-4506
Mailing Address577 Airport Blvd Ste 300Burlingame, CA 94010-2048 · (650) 240-8198
Phone(650) 652-8700
Fax(650) 652-8705
Sole ProprietorNo
Enumeration DateNovember 5, 2015
Last NPPES UpdateMay 6, 2016
✔ NPI 1912370305 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 CA · PA52946
1501 TROUSDALE DR FL 1, Burlingame, CA 94010
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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)

Jeremy Nicoloff Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SARAH CHANG
Physical Therapist
1501 TROUSDALE DR FL 1
BURLINGAME, CA 94010
San Mateo County (650) 696-4315
DARRYL SARZABA PA-C
Physician Assistant (Surgical)
1501 TROUSDALE DR FL 1
BURLINGAME, CA 94010
San Mateo County (650) 652-8700

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 Jeremy Nicoloff's NPI number?

The NPI number for Jeremy Nicoloff is 1912370305. It was assigned to this individual provider in the NPPES registry on November 5, 2015.

Where is Jeremy Nicoloff located?

Jeremy Nicoloff practices at 1501 Trousdale Dr Fl 1, Burlingame, CA 94010. The listed phone number is (650) 652-8700.

What is Jeremy Nicoloff's specialty?

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

Is Jeremy Nicoloff enrolled in Medicare?

Yes. Jeremy Nicoloff is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jeremy Nicoloff was last updated on May 6, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.