Donna Nickles

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MB03792500 Issued in NJ

Practice address

80 Eisenhower Dr
Suite 200
Paramus, NJ 07652-1401

Phone

(201) 843-2800

Fax

(973) 939-0273

NPI assigned

Oct 10, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Lifeline Medical Associates, LLC

  • Obstetrics & Gynecology Physician
  • Florham Park, NJ
  • NPI 1821041617
  NPD

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1063400547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 EISENHOWER DR",
            "address_2": "SUITE 200",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076521401",
            "telephone_number": "201-843-2800",
            "fax_number": "973-939-0273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 EISENHOWER DR",
            "address_2": "SUITE 200",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076521401",
            "telephone_number": "201-843-2800",
            "fax_number": "973-939-0273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKLES",
        "first_name": "DONNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MB03792500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO #",
            "identifier": "2807666",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS #",
            "identifier": "39F312",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR #",
            "identifier": "160055692",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET #",
            "identifier": "1K4890",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD #",
            "identifier": "P2631203",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH #",
            "identifier": "0105583000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO #",
            "identifier": "4252756",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Kuilan Newman, M.S.,R.D.
• Next Step Chiropractic LLC
• Mohammad Zafar Niazi
• Minas John Nicholas, O.D.
• Nickhil Gupta DO PC
• Emily Nicol, PA-C
• Vincenzo Nicosia, LCSW
• Niki Patel MD PA
• Kunikazu David Nishimura, PT, DPT
• Alahyar Nissany, O.D.

• Specialist in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.