Charles P. Nicholson, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

31132 Issued in MN

Practice address

6405 France Ave S
Suite W440
Edina, MN 55435-2163

Phone

(952) 927-7004

Fax

(952) 927-5146

NPI assigned

Jul 6, 2006

Last updated

Mar 8, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• C. Phifer Nicholson Other name

Medicare fee-for-service enrollment

Enrolled in MN

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

Merit-based Incentive Payment System (MIPS)

Final score

88.63 of 100Reported as group

Quality

75.41

Promoting interoperability

100

Improvement activities

40

Cost

75.75

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fairview Express Care

  dba M Health Fairview Recovery Clinic

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment NPD
• Fairview Express Care

  dba M Health Fairview Sleep Center - Minneapolis

  • Sleep Medicine (Family Medicine) Physician
  • Minneapolis, MN
  • NPI 1598203432
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Fairview Health Services

  dba Fairview Hospital University

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD
• Fairview Health Services

  dba Fairview Emergency Medical Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• Surgical Consultants, P.a.

  • Surgery Physician
  • Edina, MN
  • NPI 1366479651
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1114958097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 FRANCE AVE S",
            "address_2": "#W440",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352163",
            "telephone_number": "952-927-7004",
            "fax_number": "952-924-5146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 FRANCE AVE S",
            "address_2": "SUITE W440",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352163",
            "telephone_number": "952-927-7004",
            "fax_number": "952-927-5146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "CHARLES",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "31132",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MN",
            "license": "31132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "335792900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "770000441",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "C.",
            "last_name": "NICHOLSON",
            "middle_name": "PHIFER",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Thanh Nguyen, PHARMD
• Andrea Lynn Nibbe, CNP
• Tamara M Nice, LSW
• Donald Thomas Nicell, M.D.
• Carter J Nichols, M.D.
• Keira Lynn Nicholson, DDS
• Mary Ann Nickel, APRN, CNP
• Elenute Nicola, MD
• Vicki Lynn Niedzwieski, MS, RN
• Alyssa Nielsen

• Vascular Surgery Physician in Edina, MN
• Providers in Edina, MN by specialty
• Vascular Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.