NPIMap

Individual provider Active NPI

Elizabeth L Nicholas, MD

  • Family Medicine Physician
  • Yankton, SD
National Provider Identifier
1154776011
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12524 Issued in SD
Practice address
1104 W 8TH St
Yankton, SD 57078-3306
Phone
(605) 665-7841
Fax
(605) 665-0546
NPI assigned
Apr 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 12524 SD Primary

Addresses

Primary practice location

1104 W 8TH St
Yankton, SD 57078-3306

Mailing address

1104 W 8TH St
Yankton, SD 57078-3306
Phone (605) 665-7841

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address enicholas@direct.yanktonmedicalclinic.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, SD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190802000477 NM Practitioner - Family Practice 9537454129 Reassigns benefits to 1 organization
I20210827002501 SD Practitioner - Family Practice 9537454129 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Sanford School of Medicine of University of South Dakota, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yankton Medical Clinic PCGroup PAC ID 1850208778, 59 clinicians
Sacred Heart Health ServicesGroup PAC ID 6103729066, 151 clinicians

Practice addresses (Care Compare)

1104 W 8TH St
Yankton, SD 57078-3306
Phone (605) 665-7841

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12524SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Sep 2, 2019 Accepting new patients
Yankton Medical Clinic PC Family Medicine CurrentSince Sep 15, 2021 Accepting new patients
Sacred Heart Health Services CurrentSince Jan 1, 2026 Accepting new patients
Yankton Medical Clinic PC Current Accepting new patients
Presbyterian Healthcare Services Family Medicine CurrentSince Sep 2, 2019 Accepting new patients
Yankton Medical Clinic PC CurrentSince Sep 15, 2021 Accepting new patients
Sacred Heart Health Services CurrentSince Jan 1, 2026 Accepting new patients
Yankton Medical Clinic PC Current Accepting new patients
Sacred Heart Health Services Past Accepting new patients

Locations

5901 Harper Dr NE
Albuquerque, NM 87109
Phone (505) 823-8233

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

1104 W 8th St
Yankton, SD 57078
Phone (605) 665-7841

501 Summit St
Yankton, SD 57078
Phone (605) 655-1201

Organizations & group practices 9

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 8

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": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1154776011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 W 8TH ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570783306",
            "telephone_number": "605-665-7841",
            "fax_number": "605-665-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 W 8TH ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570783306",
            "telephone_number": "605-665-7841",
            "fax_number": "605-665-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "ELIZABETH",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-28",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "12524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "enicholas@direct.yanktonmedicalclinic.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1104 W 8th St",
            "city": "Yankton",
            "state": "SD",
            "country_code": "US",
            "postal_code": "570783306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Yankton, SD

Sources for this page

Verify at the official NPI Registry.