Individual provider Active NPI

Nicole Conkling, MD

  • Surgery of the Hand (Plastic Surgery) Physician
  • Orange, CA
National Provider Identifier
1477895779
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery of the Hand (Plastic Surgery) PhysicianTaxonomy code 2082S0105X
License
A133685 Issued in CA
Practice address
200 S Manchester Ave Ste 650
Orange, CA 92868-3224
Phone
(714) 456-3077
NPI assigned
Mar 25, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X A133685 CA
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X A133685 CA Primary

Addresses

Primary practice location

200 S Manchester Ave Ste 650
Orange, CA 92868-3224

Mailing address

200 S Manchester Ave Ste 650
Orange, CA 92868-3224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230803000768 CA Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 8921392283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of CaliforniaGroup PAC ID 2860473873, 14 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7004

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
133685CAMDClinical Social Worker
A133685CAMDSurgery of the Hand (Plastic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Single Specialty CurrentSince Sep 18, 2023 Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

19210 Jamboree Rd
Irvine, CA 92612
Phone (657) 579-7000

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

200 S Manchester Ave
Ste 300
Orange, CA 92868
Phone (714) 424-9001

200 S Manchester Ave
Ste 650
Orange, CA 92868
Phone (714) 456-3077

1451 Irvine Blvd
Tustin, CA 92780
Phone (714) 838-8408

Organizations & group practices 3

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 2

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": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1477895779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE STE 650",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE STE 650",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683224",
            "telephone_number": "714-456-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLING",
        "first_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-25",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A133685",
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "CA",
            "license": "A133685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.