Individual provider Active NPI

Richard Emery Nickowitz, MD

  • Gastroenterology Physician
  • Pasadena, CA
National Provider Identifier
1083686893
Registry record updated Feb 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G075648 Issued in CA
Practice address
50 Alessandro PL
Suite 410
Pasadena, CA 91105-3149
Phone
(626) 793-7114
Fax
(626) 793-7679
NPI assigned
Feb 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X G075648 CA Primary

Addresses

Primary practice location

50 Alessandro PL
Suite 410
Pasadena, CA 91105-3149

Mailing address

50 Alessandro Place
Suite 410
Pasadena, CA 91105-3149
Phone (626) 793-7114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081121000561 CA Practitioner - Gastroenterology 6305889882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
JS Weill Medical College, Cornell University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Genesis Healthcare Partners PCGroup PAC ID 2163606807, 232 clinicians

Practice addresses (Care Compare)

50 Alessandro PL
Suite 410
Pasadena, CA 91105-3175
Phone (626) 793-7114

Hospital & facility affiliations

  • Huntington Hospital Hospital, Pasadena, CA, CCN 050438

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy115
Upper gastrointestinal (GI) endoscopy for acid reflux117

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G075648CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skyline Urology Current Accepting new patients
Genesis Healthcare Partners PC CurrentSince Oct 1, 2022 Accepting new patients
Pasadena Endoscopy Center Inc Current Accepting new patients
Urology Institute of the South Bay Current Accepting new patients
Alliance Digestive Disease Consultants Medical Group Gastroenterology PastSince Jun 6, 2005 Accepting new patients
Pasadena Hospital Association, LTD. Past Accepting new patients
Usc Arcadia Hospital Past Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients

Locations

9850 Genesee Ave
Ste 440
La Jolla, CA 92037
Phone (858) 453-5944

50 Alessandro Pl
Ste 410
Pasadena, CA 91105
Phone (626) 793-7114

50 Alessandro Pl
Ste 440
Pasadena, CA 91105
Phone (626) 440-9190

55 Valley St
Pasadena, CA 91105
Phone (626) 397-8335

23600 Telo Ave
Ste 220
Torrance, CA 90505
Phone (310) 534-8400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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 1

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": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1083686893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 ALESSANDRO PLACE",
            "address_2": "SUITE 410",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053149",
            "telephone_number": "626-793-7114",
            "fax_number": "626-793-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ALESSANDRO PL",
            "address_2": "SUITE 410",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053149",
            "telephone_number": "626-793-7114",
            "fax_number": "626-793-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKOWITZ",
        "first_name": "RICHARD",
        "middle_name": "EMERY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G075648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.