Frederic G Nicola, M. D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

G38262 Issued in CA

Practice address

13160 Mindanao Way
Ste 300
Marina del Rey, CA 90292-6358

Phone

(310) 574-0400

Fax

(310) 574-0485

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Frederic G Nicola, MD, a Professional Corporation

  • Orthopaedic Surgery Physician
  • Marina del Rey, CA
  • NPI 1417255316
  NPD Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302739200000",
    "number": "1184736480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13160 MINDANAO WAY",
            "address_2": "STE 300",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926358",
            "telephone_number": "310-574-0400",
            "fax_number": "310-574-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13160 MINDANAO WAY",
            "address_2": "STE 300",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926358",
            "telephone_number": "310-574-0400",
            "fax_number": "310-574-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLA",
        "first_name": "FREDERIC",
        "middle_name": "G",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G38262",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G38262",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "G38262",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "CA",
            "license": "G38262",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "CA",
            "license": "G38262",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "953951031",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryant Nguyen
• Elaine Nguyen
• Joshua Nguyen
• Ngoc Nguyen, PA
• Quy Tu Nguyen, M.D.
• Daisy Nicolas
• Richard Paul Nigro, M.D.
• Doug Nishida, O.D.
• No 206 LLC
• Benjamin Noble, DO

• Specialist in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; 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.