Active NPI
Holly Nicewicz, D.O.
- Psychiatry Physician
- Tamarac, FL
National Provider Identifier
1235586181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- UO5025
- Practice address
- 7201 N University Dr
Pbcgme/University Hopsital and Medical Center
Tamarac, FL 33321-2913 - Phone
- (954) 724-6540
- NPI assigned
- May 20, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | UO5025 | FL | Primary |
Addresses
Primary practice location
7201 N University Dr
Pbcgme/University Hopsital and Medical Center
Tamarac, FL 33321-2913
Mailing address
7201 N University Dr
Pbcgme/University Hopsital and Medical Center
Tamarac, FL 33321-2913
Phone (954) 724-6540
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2022 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| UO5025 | FL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463702400000",
"number": "1235586181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7201 N UNIVERSITY DR",
"address_2": "PBCGME/UNIVERSITY HOPSITAL AND MEDICAL CENTER",
"city": "TAMARAC",
"state": "FL",
"postal_code": "333212913",
"telephone_number": "954-724-6540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7201 N UNIVERSITY DR",
"address_2": "PBCGME/UNIVERSITY HOPSITAL AND MEDICAL CENTER",
"city": "TAMARAC",
"state": "FL",
"postal_code": "333212913",
"telephone_number": "954-724-6540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICEWICZ",
"first_name": "HOLLY",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-20",
"last_updated": "2016-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "UO5025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tamarac, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.