Active NPI
Michael Nicholas, MD
- Pediatrics Physician
- Doylestown, PA
National Provider Identifier
1144242520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD-065094-L
- Practice address
- 708 Shady Retreat Rd
Suites 34
Doylestown, PA 18901 - Phone
- (215) 345-6090
- Fax
- (215) 345-6119
- NPI assigned
- Jul 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD-065094-L | PA | Primary |
Addresses
Primary practice location
708 Shady Retreat Rd
Suites 34
Doylestown, PA 18901
Mailing address
708 Shady Retreat Rd
Suites 34
Doylestown, PA 18901
Phone (215) 345-6090
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0016974540001 | Medicaid | PA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-065094-L | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital of Philadelphia | Pediatrics | Past | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1144242520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "708 SHADY RETREAT RD",
"address_2": "SUITES 34",
"city": "DOYLESTOWN",
"state": "PA",
"postal_code": "18901",
"telephone_number": "215-345-6090",
"fax_number": "215-345-6119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "708 SHADY RETREAT RD",
"address_2": "SUITES 34",
"city": "DOYLESTOWN",
"state": "PA",
"postal_code": "18901",
"telephone_number": "215-345-6090",
"fax_number": "215-345-6119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLAS",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD-065094-L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0016974540001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Doylestown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.