Timothy Nyckowski, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS16707 Issued in FL

Practice address

731 Stirling Center PL Unit 1931
Lake Mary, FL 32746-5209

Phone

(407) 436-7375

NPI assigned

Apr 9, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology and Skin Cancer Surgery Center, LLCGroup PAC ID 3779866579, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Orlando Health Hospital, Orlando, FL, CCN 100006

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Networks

• Optimum HealthCare HMO Network
• devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
• devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
• devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
• FL HMO D-SNP
• FL HMO
• FL PPO
• devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
• FL HMO C-SNP
• devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
• AL HMO
• AL HMO D-SNP
• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dermatology and Skin Cancer Surgery Center, LLC

  • Dermatology Physician
  • Oviedo, FL
  • NPI 1174078281
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Orlando Health, Inc.

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1184709057
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1003313735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7560 RED BUG LAKE RD STE 1014",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 STIRLING CENTER PL UNIT 1931",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465209",
            "telephone_number": "407-436-7375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7560 Red Bug Lake Rd Ste 1014",
            "address_purpose": "LOCATION",
            "city": "Oviedo",
            "state": "FL",
            "postal_code": "327656591",
            "country_code": "US",
            "telephone_number": "407-706-1770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4970 S US Highway 17/92",
            "address_purpose": "LOCATION",
            "city": "Casselberry",
            "state": "FL",
            "postal_code": "327073888",
            "country_code": "US",
            "telephone_number": "407-635-8012",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "422 S Alafaya Trl Ste 26",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328288984",
            "country_code": "US",
            "telephone_number": "407-538-3855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYCKOWSKI",
        "first_name": "TIMOTHY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS16707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nuerosurgery of Central Florida
• Maria Montserrat Nunez-Aponte, DDS
• Amy Christine Nunez
• Jacqueline Elizabeth Nurse, NP
• Nutrition Specialists Group LLC
• Madison O'Brien, RMHCI
• Robert W O'Brien, MA CMHC
• Adam J O'Connor
• Christopher Michael O'Connor Sr., PHD, LCSW
• Oasis of Serenity Homecare, LLC

• Dermatology Physician in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.