Individual provider Active NPI

Nickolas R Crusius

  • Nurse Practitioner
  • Bellingham, WA
National Provider Identifier
1487368296
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP70012064 Issued in WA
Practice address
2901 Squalicum Pkwy
Bellingham, WA 98225-1851
Phone
(360) 734-5400
NPI assigned
Jan 9, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201705910RN OR
Acute Care Nurse Practitioner 363LA2100X 10031480 OR
Nurse Practitioner 363L00000X AP70012064 WA Primary

Addresses

Primary practice location

2901 Squalicum Pkwy
Bellingham, WA 98225-1851

Mailing address

726 Cherry St # 214
Sumas, WA 98295-9649
Phone (520) 971-8176

Other practice location 1

1910 University Dr
Boise, ID 83725-5606
Phone (208) 426-4143

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20250812001847 WA Practitioner - Nurse Practitioner 9638600471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Sound Inpatient Physicians PLLCGroup PAC ID 5991618738, 424 clinicians

Practice addresses (Care Compare)

2901 Sqaulicum Pkwy
Bellingham, WA 98225-1851
Phone (360) 734-5400

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-4000

Hospital & facility affiliations

  • Peacehealth St Joseph Medical Center Hospital, Bellingham, WA, CCN 500030
  • Providence Seaside Hospital Hospital, Seaside, OR, CCN 381303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP70012064WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC CurrentSince Jul 26, 2025 Accepting new patients
South Sound Inpatient Physicians PLLC Nurse Practitioner Current Accepting new patients
South Sound Inpatient Physicians PLLC CurrentSince Jul 26, 2025 Accepting new patients
Peacehealth Past Accepting new patients

Locations

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

2901 Squalicum Pkwy
Bellingham, WA 98225
Phone (360) 734-5400

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

Organizations & group practices 4

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 4

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": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1487368296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 CHERRY ST # 214",
            "city": "SUMAS",
            "state": "WA",
            "postal_code": "982959649",
            "telephone_number": "520-971-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 SQUALICUM PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251851",
            "telephone_number": "360-734-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1910 University Dr",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837255606",
            "country_code": "US",
            "telephone_number": "208-426-4143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUSIUS",
        "first_name": "NICKOLAS",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-09",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201705910RN",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OR",
            "license": "10031480",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP70012064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.