Individual provider Active NPI

Allen Daniel Nicholson, M.D.

  • Orthopaedic Surgery Physician
  • New Haven, CT
National Provider Identifier
1184002230
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
25MA11115400 Issued in NJ
Practice address
800 Howard Ave
Ybp 133, Ynhh Dept of Orthopedics
New Haven, CT 06519-1369
Phone
(203) 785-2579
NPI assigned
May 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Surgery Physician 207X00000X 25MA11115400 NJ Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 301928 NY

Addresses

Primary practice location

800 Howard Ave
Ybp 133, Ynhh Dept of Orthopedics
New Haven, CT 06519-1369

Mailing address

776 Shrewsbury Ave Ste 201
Tinton Falls, NJ 07724-4507
Phone (732) 530-4949

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address anicholson132898@direct.HSS.edu Direct
Direct Messaging Address anicholson132898@direct.HSS.edu Direct
FHIR URL https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2 Direct
FHIR URL https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/ Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20210820002795 NJ Practitioner - Orthopedic Surgery 7214240282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Yale University School of Medicine, 2015
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

776 Shrewsbury Ave
Suite 201
Tinton Falls, NJ 07724-4507
Phone 7325304949240

Hospital & facility affiliations

  • Visiting Nurse Association of Central Jersey Home Care and Hospice Home health agency, Toms River, NJ, CCN 317067
  • Monmouth Medical Center Hospital, Long Branch, NJ, CCN 310075
  • Riverview Medical Center Hospital, Red Bank, NJ, CCN 310034
  • St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019
  • Jersey Shore University Medical Center Hospital, Neptune, NJ, CCN 310073
  • Ocean Medical Center Hospital, Brick, NJ, CCN 310052
  • Kessler Rehab Center Inpatient rehabilitation facility, West Orange, NJ, CCN 313025

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)261

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
301928NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Orthopaedic Assoc PA Orthopaedic Surgery CurrentSince Aug 1, 2021 Accepting new patients
Professional Orthopedics Assoc PastSince Apr 25, 2021 Accepting new patients

Locations

303 W Main St
Ste 1
Freehold, NJ 07728
Phone (732) 577-0027

776 Shrewsbury Ave
Ste 102
Tinton Falls, NJ 07724
Phone (732) 590-4949

776 Shrewsbury Ave
Ste 201
Tinton Falls, NJ 07724
Phone (732) 530-4949

776 Shrewsbury Ave
Tinton Falls, NJ 07724
Phone (732) 530-4949

776 Shrewsbury Ave
Ste 105
Tinton Falls, NJ 07724
Phone (732) 530-4949

1430 Hooper Ave
Ste 101
Toms River, NJ 08753

1430 Hooper Ave
Toms River, NJ 08753
Phone (732) 240-2277

Interoperability endpoints

  • Direct secure messaging: anicholson132898@direct.hss.edu

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.

Hospital & facility affiliations 11

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": "1431129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1184002230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "776 SHREWSBURY AVE STE 201",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077244507",
            "telephone_number": "732-530-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 HOWARD AVE",
            "address_2": "YBP 133, YNHH DEPT OF ORTHOPEDICS",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191369",
            "telephone_number": "203-785-2579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "ALLEN",
        "middle_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-09",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NJ",
            "license": "25MA11115400",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NY",
            "license": "301928",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anicholson132898@direct.HSS.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "776 Shrewsbury Ave Ste 201",
            "city": "Tinton Falls",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "077244507",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anicholson132898@direct.HSS.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "535 E 70th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100214823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "535 E 70th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100214823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "535 E 70th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100214823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.