Nicklaus Nishijima

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E6118 Issued in CA

Practice address

2067 W Vista Way Ste 265
Vista, CA 92083-6034

Phone

(760) 463-9155

NPI assigned

May 31, 2021

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

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

California School of Podiatric Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

S Luke Berthelsen DPM IncGroup PAC ID 0941564371, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scripps Memorial Hospital - Encinitas Hospital, Encinitas, CA, CCN 050503
• Tri-City Medical Center Hospital, Oceanside, CA, CCN 050128

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: foundation.nicklausnishijima@146737.advancedmd-direct.com

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.

• S. Luke Berthelsen DPM, Inc

  • Foot & Ankle Surgery Podiatrist
  • Vista, CA
  • NPI 1821598004
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Scripps Health

  • General Acute Care Hospital
  • Encinitas, CA
  • NPI 1700829199
  Care Compare affiliation
• Tri-City Hospital

  • General Acute Care Hospital
  • Oceanside, CA
  • NPI 1801861190
  Care Compare affiliation

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

{
    "created_epoch": "1622419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1144896234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2067 W VISTA WAY STE 265",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836034",
            "telephone_number": "760-463-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2067 W VISTA WAY STE 265",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836034",
            "telephone_number": "760-463-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHIJIMA",
        "first_name": "NICKLAUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-31",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E6118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Christina Nielsen, BA
• Shelby Nielsen
• Myrna Nieto
• Nieva Socorro R. Bautista D.M.D., Inc
• Maxwell G Niggli
• Moena Nishikawa
• Jeffrey Kent Niss, CCAPP C7801214
• Norbert Charles Nitsch III, PT
• No Vacancy, Inc.
• Noble Ama Ipa

• Foot & Ankle Surgery Podiatrist in Vista, CA
• Providers in Vista, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; 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.