Nicole Alicia Lytle, PA is a medicare enrolled "Physician Assistant" physician in Athens, Georgia. Her current practice location is
1199 Prince Ave, Athens, Georgia. You can reach out to her office (for appointments etc.) via phone at
(478) 464-8134.
Nicole Alicia Lytle is licensed to practice in Georgia (license number 3771) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1174654651.
Physician's Profile
Full Name | Nicole Alicia Lytle |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 1199 Prince Ave, Athens, Georgia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1174654651
- Provider Enumeration Date: 03/08/2007
- Last Update Date: 05/07/2024
Medicare PECOS Information:
- PECOS PAC ID: 0446239255
- Enrollment ID: I20040715000915
Medical Identifiers
Medical identifiers for Nicole Alicia Lytle such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1174654651 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2084P0800X | Psychiatry & Neurology - Psychiatry | 3771 (Georgia) | Secondary |
363A00000X | Physician Assistant | 3771 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicole Alicia Lytle is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Nicole Alicia Lytle, PA 503 Saint Marlo Dr, Centerville, GA 31028-8005 Ph: (478) 953-1345 | Nicole Alicia Lytle, PA 1199 Prince Ave, Athens, GA 30606-2797 Ph: (478) 464-8134 |
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