Joshua Nickerson, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

OS019814 Issued in PA

Practice address

4641 E Roosevelt Blvd
Philadelphia, PA 19124-2343

Phone

(800) 889-0548

NPI assigned

May 23, 2016

Last updated

Nov 13, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, CO, IL, WI4 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

Psychiatry

Education

Philadelphia College of Osteopathic Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Presence Healthcare ServicesGroup PAC ID 2860396769, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Presence Saint Joseph Hospital - Chicago Hospital, Chicago, IL, CCN 140224

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/crossroadstp/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Presence Healthcare Services

  dba Presence Medical Group

  • Multi-Specialty Clinic/Center
  • Elk Grove Village, IL
  • NPI 1932216819
  Medicare reassignment Care Compare group NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment NPD
• Bonaventure Medical Foundation, LLC

  dba Alexian Brothers Medical Foundation

  • Family Medicine Physician
  • Elk Grove Village, IL
  • NPI 1588775647
  Medicare reassignment NPD
• Community Reach Center, Inc

  • Community/Behavioral Health Agency
  • Thornton, CO
  • NPI 1316906886
  Medicare reassignment NPD
• Crossroads Turning Points Inc

  • Methadone Clinic
  • Pueblo, CO
  • NPI 1619272754
  Medicare reassignment NPD (past)
• Ascension Medical Group-Southeast Wisconsin Inc

  dba Ascension Medical Group

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077
  Medicare reassignment
• Geisinger Clinic

  • Family Medicine Physician
  • Scranton, PA
  • NPI 1184248668
  NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD
• Community Reach Center, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Broomfield, CO
  • NPI 1841887056
  NPD
• Crossroads Turning Points Inc

  • Methadone Clinic
  • Lamar, CO
  • NPI 1205668761
  NPD
• Crossroads Turning Points Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Colorado Springs, CO
  • NPI 1801418660
  NPD
• Presence Healthcare Services

  • Internal Medicine Physician
  • Bolingbrook, IL
  • NPI 1043748338
  NPD

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

• Presence Chicago Hospitals Network

  dba Presence Saint Joseph Hospital-Chicago

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1679659585
  Care Compare affiliation

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

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1386091130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-271-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 E ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191242343",
            "telephone_number": "800-889-0548"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "781 Far Hills Dr",
            "address_purpose": "LOCATION",
            "city": "New Freedom",
            "state": "PA",
            "postal_code": "173498447",
            "country_code": "US",
            "telephone_number": "717-812-2560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8931 Huron St",
            "address_purpose": "LOCATION",
            "city": "Thornton",
            "state": "CO",
            "postal_code": "802606806",
            "country_code": "US",
            "telephone_number": "303-853-3500",
            "fax_number": "303-853-3702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 N Academy Ave",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "PA",
            "postal_code": "178229800",
            "country_code": "US",
            "telephone_number": "570-271-6211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2900 N Lake Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575640",
            "country_code": "US",
            "telephone_number": "773-665-4988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "JOSHUA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-23",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0068432",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "OS019814",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036177295",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise M Nicholson
• John David Nicholson Jr., PA
• Keith Nicholson, D.D.S
• Liberty Nickelsberg, CRNA
• Jennifer Nickerson, CRNA
• Amanda Nickles
• Sean Michael Nickley, PH.D.
• David E Nicklin, MD
• Katelyn Elizabeth Nicklow, M.S., BCBA
• Julie Marie Nickman, D.M.D.

• Psychiatry Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; 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.