Esther Yoon Nickelson, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

161969 Issued in MT

Practice address

411 Grand Ave
Oakland, CA 94610-5022

Phone

(510) 844-4097

NPI assigned

Nov 23, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: enickelson@carbonhealth.com
• Direct secure messaging: esther.nickelson.1@30520.direct.athenahealth.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.

• Bozeman Health Deaconess Hospital

  • Durable Medical Equipment & Medical Supplies
  • Bozeman, MT
  • NPI 1013733955
  NPD
• Bozeman Health Deaconess Hospital

  • Emergency Medicine Physician
  • Bozeman, MT
  • NPI 1437529112
  NPD
• Bozeman Health Deaconess Hospital

  • Family Medicine Physician
  • Bozeman, MT
  • NPI 1619347390
  NPD
• Bozeman Health Deaconess Hospital

  • General Acute Care Hospital
  • Bozeman, MT
  • NPI 1104295864
  NPD (past)

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

{
    "created_epoch": "1574467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1164068268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2146 CLINTON AVE APT B",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945016604",
            "telephone_number": "406-209-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 GRAND AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946105022",
            "telephone_number": "510-844-4097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 Harrison St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946123788",
            "country_code": "US",
            "telephone_number": "406-209-1678",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2920 Telegraph Ave",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947052031",
            "country_code": "US",
            "telephone_number": "510-686-3621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKELSON",
        "first_name": "ESTHER",
        "middle_name": "YOON",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-23",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MT",
            "license": "161968",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95154363",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013748",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "161969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164068268",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Enickelson@carbonhealth.com",
            "affiliation": "N",
            "address_1": "411 Grand Ave",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946105022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "enickelson17251434@direct.sanfordhealth.org",
            "affiliation": "Y",
            "affiliationName": "Bozeman Health Urgent Care",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1006 W Main St",
            "city": "Bozeman",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597153219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicholas Hack Psychotherapy, Inc.
• Chelsea S Nicholas, PT
• Czar Nicholas
• D. Jeanette Nichols
• Scott Lee Nickell, MSN, FNP
• John Thomas Nickens, PHD
• Lena Nicodemus, MA, LMFT
• Natasha L Nicolai, DPT
• Arrian Tolentino Nicolas
• Heidi Gayle Nicoll-Merson, MD

• Nurse Practitioner in Oakland, CA
• Providers in Oakland, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.