Jamie Nichols, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7652-23 Issued in WI

Practice address

1111 Delafield St Ste 102
Waukesha, WI 53188-3402

Phone

(262) 683-8455

NPI assigned

Oct 2, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Nova Southeastern Univ College of Dental Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Moreland Ear Nose and Throat Group LTDGroup PAC ID 4284605494, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Moreland Ear Nose & Throat Group LTD

  • Specialist
  • Waukesha, WI
  • NPI 1861464182
  Medicare reassignment Care Compare group

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

• Prohealth Waukesha Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Waukesha, WI
  • NPI 1629056890
  Care Compare affiliation

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1295515724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 FOX RIVER PKWY",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531897747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 DELAFIELD ST STE 102",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883402",
            "telephone_number": "262-683-8455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 Maple Ave",
            "address_purpose": "LOCATION",
            "city": "Mukwonago",
            "state": "WI",
            "postal_code": "531498475",
            "country_code": "US",
            "telephone_number": "262-683-8455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "195 Discovery Dr",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530452862",
            "country_code": "US",
            "telephone_number": "262-683-8455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1185 Corporate Center Dr Ste 205",
            "address_purpose": "LOCATION",
            "city": "Oconomowoc",
            "state": "WI",
            "postal_code": "530664887",
            "country_code": "US",
            "telephone_number": "262-683-8455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13900 W National Ave",
            "address_purpose": "LOCATION",
            "city": "New Berlin",
            "state": "WI",
            "postal_code": "531519515",
            "country_code": "US",
            "telephone_number": "262-683-8455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JAMIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7652-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Life Resources, Inc.
• Sarah Newburg, PA-C
• Amanda T Nguyen
• Lisa Nguyen
• Dawn L Nichols, OTR
• Laurie Nick, RDH
• Samantha Elizabeth Nickell, DPT
• Patricia Nicks, RDH
• Nicole L B Sternitzky MD SC
• Kathryn A Nieman, OTR

• Physician Assistant in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.