Nickisha Naulie Berlus, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD61245514 Issued in WA

Practice address

32018 23Rd Ave S
Federal Way, WA 98003-6022

Phone

(206) 520-5000

NPI assigned

Apr 25, 2012

Last updated

Aug 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT, NY, WA3 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 3

Specialty

Family Practice

Education

Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

King County FinanceGroup PAC ID 8022913789, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Valley Medical Center Hospital, Renton, WA, CCN 500088

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: nberlus745713@direct.ochin.org
• Direct secure messaging: nberlus787043@direct.multicare.org

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.

• King County Finance

  dba Seattle-King County Dept of Public Health

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1306903604
  Medicare reassignment Care Compare group NPD
• Valley Medical Group-Renton

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1619209574

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Sea Mar Community Health Centers

  dba Sea Mar Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Aberdeen, WA
  • NPI 1811051170

  Family Medicine

  Medicare reassignment NPD
• Divinity Medical Services PLLC

  dba AFC Urgent Care Yorktown

  • Urgent Care Clinic/Center
  • Yorktown Heights, NY
  • NPI 1497159560
  Medicare reassignment NPD
• Hartford Healthcare Medical Group, Inc

  dba Hartford HealthCare Medical Group

  • Surgery Physician
  • Wethersfield, CT
  • NPI 1043561301

  Family Medicine

  Medicare reassignment NPD
• Optum Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Jericho, NY
  • NPI 1285975797
  Medicare reassignment NPD
• King County Finance

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1518593904
  NPD
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Tacoma, WA
  • NPI 1104974419

  Family Medicine

  NPD
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Spanaway, WA
  • NPI 1922624642
  NPD
• Association of University Physicians

  dba University of Washington Physicians

  • Anesthesiology Physician
  • Seattle, WA
  • NPI 1093736621
  NPD (past)
• Tri Cities Community Health

  • Federally Qualified Health Center (FQHC)
  • Pasco, WA
  • NPI 1659995504
  NPD (past)

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

• Public Hospital District 1 of King County

  dba Valley Medical Center

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1649209230
  Care Compare affiliation
• Valley Medical Group-Renton

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1619209574
  Care Compare affiliation

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1609134873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "telephone_number": "253-681-6626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32018 23RD AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036022",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1112 S Cushman Ave",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984053631",
            "country_code": "US",
            "telephone_number": "253-593-2144",
            "fax_number": "253-246-6725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERLUS",
        "first_name": "NICKISHA",
        "middle_name": "NAULIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-25",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61245514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marinah Bentley
• Heidi Marguerite Benz-Merritt
• Reilly Benz, PHARM. D
• Mary Pat Bergin, RN
• Samantha Bergstrom, FNP-BC
• Jeremy Berman
• Ann Berryman, CCC/SLP
• Best Care Chiropractic and Wellness Inc.
• Beverly Renee Beste
• Dorinda K Betcher, LMP

• Family Medicine Physician in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.