Jaime A Nicacio, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD00038624 Issued in WA

Practice address

400 NE Mother Joseph PL
Vancouver, WA 98664-3200

Phone

(360) 514-3142

Fax

(360) 514-6809

NPI assigned

Oct 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, OR, SD, ID4 enrollments

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 4

Specialty

Physical Medicine and RehabilitationAlso: Pain Management

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services - WashingtonGroup PAC ID 2860552973, 266 clinicians

Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Mary Medical Center Hospital, Walla Walla, WA, CCN 500002
• Salem Hospital Hospital, Salem, OR, CCN 380051
• Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058
• Providence St Mary Medical Center Inpatient rehabilitation facility, Walla Walla, WA, CCN 50T002
• Salem Hospital Inpatient rehabilitation facility, Salem, OR, CCN 38T051

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jnicacio35141@direct.salemhealth.org
• Direct secure messaging: jnicacio1131059@wm.providencedirect.org

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.

• Providence Health & Services - Washington

  dba Providence Medical Group Southeast Washington

  • Family Medicine Physician
  • Walla Walla, WA
  • NPI 1922259738
  Medicare reassignment Care Compare group NPD
• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Medicare reassignment Care Compare group
• Lourdes Hospital LLC

  • Internal Medicine Physician
  • Pasco, WA
  • NPI 1659861060
  Medicare reassignment NPD
• Lourdes Hospital LLC

  dba Lourdes Medical Center

  • Critical Access Hospital
  • Pasco, WA
  • NPI 1831284280
  Medicare reassignment NPD
• Monument Health Rapid City Hospital, Inc

  dba Monument Health Behavioral Health Center

  • Multi-Specialty Clinic/Center
  • Rapid City, SD
  • NPI 1275553463
  Medicare reassignment NPD
• Saint Alphonsus Regional Medical Center Inc

  • Psychologist
  • Boise, ID
  • NPI 1649357716
  Medicare reassignment NPD
• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  Medicare reassignment
• Providence Health & Services - Washington

  dba Providence Medical Group Southeast Washington Radiation Oncology

  • Radiation Oncology Physician
  • Walla Walla, WA
  • NPI 1982856886
  NPD
• Monument Health Rapid City Hospital Inc

  dba Monument Health Rapid Valley Clinic

  • Urgent Care Clinic/Center
  • Rapid City, SD
  • NPI 1215727854
  NPD
• Saint Alphonsus Regional Medical Center Inc

  • Psychiatric Hospital Unit
  • Boise, ID
  • NPI 1770687857
  NPD
• Saint Alphonsus Regional Medical Center Inc

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1992736649
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  Care Compare affiliation
• Providence Health & Services - Washington

  dba Providence St Mary Medical Center

  • General Acute Care Hospital
  • Walla Walla, WA
  • NPI 1386895886
  Care Compare affiliation
• Providence Health & Services - Washington

  • Rehabilitation Hospital Unit
  • Walla Walla, WA
  • NPI 1467603282

  Inpatient rehabilitation facility

  Care Compare affiliation
• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Care Compare affiliation

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1245314608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL",
            "address_2": "SUITE 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643299",
            "telephone_number": "360-514-3142",
            "fax_number": "360-514-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NE MOTHER JOSEPH PL",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643200",
            "telephone_number": "360-514-3142",
            "fax_number": "360-514-6809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 N Curtis Rd",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061445",
            "country_code": "US",
            "telephone_number": "208-605-3000",
            "fax_number": "208-605-3395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICACIO",
        "first_name": "JAIME",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "ID",
            "license": "M-16759",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MD00038624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thuan Huy Nguyen, CRNA
• Trung Quoc Nguyen, LMP, LMT
• Victor Duc-Thang Nguyen, MD
• Viet Quoc Nguyen, M.D.
• Vinh Xuan Nguyen, PHARMD
• Nicholas F. Carulli MD, PC (Carulli Medical Clinic)
• Nicholas Raklios, DDS, PLLC (Must Love Kids Pediatric Dentistry)
• Shannon La Rae Nicholles
• Stephen Nicholls, M.D.
• Cassandra Marie Nichols

• Physical Medicine & Rehabilitation Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Physical Medicine & Rehabilitation Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.