Individual provider Active NPI

Judd Karl Nicholas, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Monterey, CA
National Provider Identifier
1104933647
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
A30375 Issued in CA
Practice address
23625 Holman Hwy
Monterey, CA 93940-5902
Phone
(831) 624-5311
Fax
(831) 625-4948
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A30375 CA
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X A30375 CA Primary

Addresses

Primary practice location

23625 Holman Hwy
Monterey, CA 93940-5902

Mailing address

P O Box HH
Business Development & Contracting
Monterey, CA 93942
Phone (831) 622-2716

Other identifiers 1

IdentifierTypeStateIssuer
00A303750OtherCABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A30375CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital of the Monterey Peninsula Current Accepting new patients
Monterey Bay Emergency Physicians Medical Corporation Emergency Medicine Past Accepting new patients
Eric Mowatt-Larssen, MD, Inc Past Accepting new patients

Locations

23625 Wr Holman Hwy
Monterey, CA 93940
Phone (831) 622-2708

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1104933647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX HH",
            "address_2": "BUSINESS DEVELOPMENT & CONTRACTING",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "93942",
            "telephone_number": "831-622-2716",
            "fax_number": "831-625-4764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23625 HOLMAN HWY",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405902",
            "telephone_number": "831-624-5311",
            "fax_number": "831-625-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "JUDD",
        "middle_name": "KARL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A30375",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "CA",
            "license": "A30375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A303750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.