Adam Foster Nicholson, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

12119 Issued in ND

Practice address

4440 S Washington St - Altru Professional Center
Grand Forks, ND 58201

Phone

(701) 732-7000

NPI assigned

Jun 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ND, MN2 enrollments

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 2

Specialty

Urology

Education

Tulane University School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Altru Health SystemGroup PAC ID 1355251604, 675 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Altru Hospital Hospital, Grand Forks, ND, CCN 350019
• Lifecare Medical Center Hospital, Roseau, MN, CCN 241344
• Pembina County Memorial Hospital Hospital, Cavalier, ND, CCN 351319
• First Care Health Center Hospital, Park River, ND, CCN 351326
• Unity Medical Center Hospital, Grafton, ND, CCN 351320

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Altru Health System

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1043309552
  Medicare reassignment Care Compare group NPD
• Altru Health System

  • Clinic/Center
  • Crookston, MN
  • NPI 1760494330
  Medicare reassignment NPD
• Altru Health System

  • Ambulance
  • Grand Forks, ND
  • NPI 1114485315
  NPD
• Altru Health System

  • Rural Health Clinic/Center
  • Warroad, MN
  • NPI 1689763195
  NPD
• Clinic Pharmacy Inc

  • Community/Retail Pharmacy
  • Devils Lake, ND
  • NPI 1184718876
  NPD (past)

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

• Altru Health System

  • General Acute Care Hospital
  • Grand Forks, ND
  • NPI 1154346161
  Care Compare affiliation
• Christian Unity Hospital Corporation

  • Critical Access Hospital
  • Grafton, ND
  • NPI 1245216852
  Care Compare affiliation
• P R Health Corporation

  • Critical Access Hospital
  • Park River, ND
  • NPI 1679669741
  Care Compare affiliation
• Pembina County Memorial Hospital Association

  • Critical Access Hospital
  • Cavalier, ND
  • NPI 1760542500
  Care Compare affiliation
• Lifecare Medical Center

  • Critical Access Hospital
  • Roseau, MN
  • NPI 1609861095
  Care Compare affiliation

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1063619237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-780-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 S WASHINGTON ST - ALTRU PROFESSIONAL CENTER",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-732-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "ADAM",
        "middle_name": "FOSTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MN",
            "license": "49436",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MS",
            "license": "21482",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ND",
            "license": "12119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anicholson65378@direct.directaltru.org",
            "affiliation": "N",
            "endpointDescription": "Direct Mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4440 S Washington St - Altru Professional Center",
            "city": "Grand Forks",
            "state": "ND",
            "country_code": "US",
            "postal_code": "58201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anna Nguyen, M.A.
• Michael Nguyen, MD
• Thuy Nguyen, M.D.
• Tien-Huy Cong Nguyen
• Cameron Nichols
• Timothy Nicholson
• Amber Michelle Nickerson, MS CF SLP
• Erik Niec, M.D.
• A Marc Nielsen, MD
• Sonya Kay Nielson, M.S. CCC-SLP

• Urology Physician in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Urology Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.