Individual provider Active NPI

Justin Scott Nichols, MD

  • Pediatrics Physician
  • San Diego, CA
National Provider Identifier
1568966893
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A199683 Issued in CA
Practice address
3020 Childrens Way
San Diego, CA 92123-4223
Phone
(858) 966-5841
NPI assigned
Mar 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A199683 CA
Pediatrics Physician 208000000X A199683 CA Primary

Addresses

Primary practice location

3020 Childrens Way
San Diego, CA 92123-4223

Mailing address

3020 Childrens Way # Mc5003
San Diego, CA 92123-4223
Phone (858) 309-6300

Other practice location 1

501 W 14th St
Wilmington, DE 19801-1013
Phone (302) 320-4411

Other practice location 2

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 320-4411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, CA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20220514000034 MD Practitioner - Internal Medicine 0547515728 Reassigns benefits to 1 organization
I20250210000789 CA Practitioner - Hospitalist 0547515728 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Temple University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 249-6748

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A199683CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital of Cecil County Internal Medicine CurrentSince Apr 1, 2022 Accepting new patients
Rady Children'S Hospital San Diego CurrentSince Aug 1, 2025 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California - Ucsd Medical Group CurrentSince Dec 27, 2024 Accepting new patients
Rady Children'S Hospital San Diego Pediatrics CurrentSince Aug 1, 2025 Accepting new patients
Regents of the University of California CurrentSince Dec 27, 2024 Accepting new patients
Union Hospital of Cecil County CurrentSince Apr 1, 2022 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation PastSince Mar 11, 2025 Accepting new patients

Locations

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

File 57326
Los Angeles, CA 90074

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277

3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

4755 Ogletown Stanton Rd
Ste 5A43
Newark, DE 19718
Phone (302) 623-0188

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

Organizations & group practices 9

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": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1568966893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-5841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 W 14th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198011013",
            "country_code": "US",
            "telephone_number": "302-320-4411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4755 Ogletown Stanton Rd",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197182200",
            "country_code": "US",
            "telephone_number": "302-320-4411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JUSTIN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A199683",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A199683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.