Individual provider Active NPI

Michael James Nickas, D.O.

  • Emergency Medicine Physician
  • Bronx, NY
National Provider Identifier
1417334459
Registry record updated Mar 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
298833 Issued in NY
Practice address
4422 3Rd Ave
Bronx, NY 10457-2594
Phone
(718) 960-6600
NPI assigned
Apr 28, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 298833 NY
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X 298833 NY Primary

Addresses

Primary practice location

4422 3Rd Ave
Bronx, NY 10457-2594

Mailing address

4422 3Rd Ave
4TH Floor Braker Building: Em Dept
Bronx, NY 10457-2545

Other practice location 1

701 N Broadway
Sleepy Hollow, NY 10591-1020
Phone (914) 366-3000

Other practice location 2

400 E Main St
Mount Kisco, NY 10549-3417
Phone (914) 996-4961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20200911001168 NY Practitioner - Emergency Medicine 7517385289 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City Medical of Upper East Side PLLCGroup PAC ID 0648465039, 658 clinicians

Practice addresses (Care Compare)

193 W 237TH St
Bronx, NY 10463-4141
Phone (718) 303-0479

Hospital & facility affiliations

  • St Barnabas Hospital Hospital, Bronx, NY, CCN 330399

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
298833NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC Multi-Specialty Current Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Oct 30, 2020 Accepting new patients
North Shore - Lij Medical PC Multi-Specialty CurrentSince Jul 18, 2023 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Oct 30, 2020 Accepting new patients

Locations

2248 31st St
Astoria, NY 11105
Phone (718) 267-1333

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

193 W 237th St
Bronx, NY 10463
Phone (718) 303-0479

400 E Main St
Mount Kisco, NY 10549
Phone (914) 666-1200

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

300 Community Dr
Plandome, NY 11030

701 N Broadway
Sleepy Hollow, NY 10591
Phone (914) 366-3140

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: michael.nickas.1@2983.direct.athenahealth.com
  • Direct secure messaging: mnickas19551@sbhny.direct-ci.net

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1417334459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE",
            "address_2": "4TH FLOOR BRAKER BUILDING: EM DEPT",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572594",
            "telephone_number": "718-960-6600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 N Broadway",
            "address_purpose": "LOCATION",
            "city": "Sleepy Hollow",
            "state": "NY",
            "postal_code": "105911020",
            "country_code": "US",
            "telephone_number": "914-366-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 E Main St",
            "address_purpose": "LOCATION",
            "city": "Mount Kisco",
            "state": "NY",
            "postal_code": "105493417",
            "country_code": "US",
            "telephone_number": "914-996-4961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKAS",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-28",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "298833",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "298833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.