Individual provider Active NPI

Nicholas Nicchitta, DO

  • Family Medicine Physician
  • Bettendorf, IA
National Provider Identifier
1053050484
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO-06562 Issued in IA
Practice address
2140 53Rd Ave
Bettendorf, IA 52722-6279
Phone
(563) 421-5700
Fax
(563) 421-5709
NPI assigned
Jun 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO-06562 IA Primary

Addresses

Primary practice location

2140 53Rd Ave
Bettendorf, IA 52722-6279

Mailing address

2140 53Rd Ave
Bettendorf, IA 52722-6279
Phone (563) 421-5700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nicholas.nicchitta@direct.genesishealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20251022004173 IA Practitioner - Family Practice 8729464508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Health SystemGroup PAC ID 7214841436, 217 clinicians

Practice addresses (Care Compare)

2140 53Rd Ave
Bettendorf, IA 52722-6279
Phone (563) 421-5700

Hospital & facility affiliations

  • Genesis Vna Home health agency, Bettendorf, IA, CCN 167012
  • Genesis HLTH System Dba Genesis MDL Ctr-Illini Hospital, Silvis, IL, CCN 140275
  • Genesis Medical Center-Davenport Hospital, Davenport, IA, CCN 160033

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System Family Medicine CurrentSince Aug 16, 2025 Accepting new patients
Genesis Health System CurrentSince Aug 16, 2025 Accepting new patients
Genesis Health System Family Medicine Past Accepting new patients

Locations

2140 53rd Ave
Bettendorf, IA 52722
Phone (563) 421-5700

210 W 53rd St
Davenport, IA 52806
Phone (563) 386-3436

1345 W Central Park Ave
Davenport, IA 52804
Phone (563) 421-4400

619 5th St
Durant, IA 52747
Phone (563) 785-4487

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1053050484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 53RD AVE",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527226279",
            "telephone_number": "563-421-5700",
            "fax_number": "563-421-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 53RD AVE",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527226279",
            "telephone_number": "563-421-5700",
            "fax_number": "563-421-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICCHITTA",
        "first_name": "NICHOLAS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-02",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "DO-06562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicholas.nicchitta@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1345 W Central Park Ave",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528041844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

Verify at the official NPI Registry.