Individual provider Active NPI

Michael Dustin Nicolay, M.D.

  • Anesthesiology Physician
  • Baltimore, MD
National Provider Identifier
1063875375
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
D93130 Issued in MD
Practice address
1420 Key Hwy # 400
Baltimore, MD 21230-5546
Phone
(730) 639-7480
NPI assigned
Apr 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X D93130 MD Primary

Addresses

Primary practice location

1420 Key Hwy # 400
Baltimore, MD 21230-5546

Mailing address

613 S Bayshore Blvd
Safety Harbor, FL 34695-4003

Other practice location 1

One Childrens Place
4401 Penn Ave
Pittsburgh, PA 15224
Phone (412) 692-5325

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CHP@upmcdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20231004001910 PA Practitioner - Anesthesiology 9638591365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.94 of 100Reported as group
Quality
61.89
Promoting interoperability
100
Improvement activities
40
Cost
74.58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D93130MDMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince Nov 1, 2023 Accepting new patients
University of Pittsburgh Physicians Anesthesiology CurrentSince Nov 1, 2023 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients

Locations

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

815 Freeport Rd
Pittsburgh, PA 15215
Phone (412) 784-4000

4401 Penn Ave
Pittsburgh, PA 15224
Phone (412) 692-5030

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1063875375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 S BAYSHORE BLVD",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346954003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 KEY HWY # 400",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212305546",
            "telephone_number": "730-639-7480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "One Childrens Place",
            "address_2": "4401 Penn Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "15224",
            "country_code": "US",
            "telephone_number": "412-692-5325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICOLAY",
        "first_name": "MICHAEL",
        "middle_name": "DUSTIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-04",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D93130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CHP@upmcdirect.com",
            "affiliation": "N",
            "address_1": "600 Grant St Fl 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.