Individual provider Active NPI

Alyse Nikolao, FNP, CNM

  • Advanced Practice Midwife
  • Tacoma, WA
National Provider Identifier
1063879088
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
AP60932557 Issued in WA
Practice address
1608 S J St
Tacoma, WA 98405-4930
Phone
(253) 274-7501
Fax
(253) 274-7926
NPI assigned
Jan 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60436839 WA
Nurse Practitioner 363L00000X AP60932557 WA
Advanced Practice Midwife 367A00000X AP60932559 WA
Advanced Practice Midwife 367A00000X AP60932557 WA Primary

Addresses

Primary practice location

1608 S J St
Tacoma, WA 98405-4930

Mailing address

1608 S J St
Tacoma, WA 98405-4930
Phone (253) 274-7501

Other identifiers 1

IdentifierTypeStateIssuer
2132960MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address anikolao608147@fhsce.catholichealth.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190520002268 WA Practitioner - Certified Nurse Midwife (CNM) 4587915236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1608 S J St
FL 1
Tacoma, WA 98405-4930
Phone (253) 274-7501

Hospital & facility affiliations

  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN60436839WAMDRegistered Nurse
AP60932557WAMDAdvanced Practice Midwife
AP60932559WAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Jun 15, 2020 Accepting new patients
Franciscan Medical Group CurrentSince Jun 15, 2020 Accepting new patients
Franciscan Health System Past Accepting new patients
My Other Me PastSince Jul 9, 2018 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: anikolao608147@fhsce.catholichealth.net

Organizations & group practices 5

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": "1453334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1063879088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 S J ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054930",
            "telephone_number": "253-274-7501",
            "fax_number": "253-274-7926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 S J ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054930",
            "telephone_number": "253-274-7501",
            "fax_number": "253-274-7926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKOLAO",
        "first_name": "ALYSE",
        "credential": "FNP, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-21",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60436839",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60932557",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WA",
            "license": "AP60932559",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WA",
            "license": "AP60932557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2132960",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anikolao608147@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1608 S J St",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.