NPIMap

Individual provider Active NPI

Robert Nicholas, MD

  • Otolaryngology Physician
  • Yankton, SD
National Provider Identifier
1609221563
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
12813 Issued in SD
Practice address
2525 Fox Run Pkwy Ste 101
Yankton, SD 57078-5371
Phone
(605) 665-0062
Fax
(605) 665-0076
NPI assigned
Apr 28, 2016
Last updated
Aug 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 12813 SD Primary
Otolaryngology Physician 207Y00000X 33769 NE

Addresses

Primary practice location

2525 Fox Run Pkwy Ste 101
Yankton, SD 57078-5371

Mailing address

1104 W 8TH St
Yankton, SD 57078-3306
Phone (605) 665-7841

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rnicholas@direct.yanktonmedicalclinic.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, SD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210811002825 NE Practitioner - Otolaryngology 7012200108 Reassigns benefits to 2 organizations
I20211028002649 SD Practitioner - Otolaryngology 7012200108 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Sanford School of Medicine of University of South Dakota, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health ServicesGroup PAC ID 6103729066, shared by 17 NPIs, 151 clinicians
Yankton Medical Clinic PCGroup PAC ID 1850208778, 59 clinicians

Practice addresses (Care Compare)

2525 Fox Run Pkwy
Suite 100
Yankton, SD 57078-5371
Phone (605) 260-0918

3901 W Norfolk Ave
Suite C
Norfolk, NE 68701-9218
Phone (402) 844-8110

3901 W Norfolk Ave
Yankton Medical Clinic Avera
Norfolk, NE 68701-4405
Phone (605) 655-7841

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Skin biopsy13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33769NEMDOtolaryngology Physician
12813SDMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health Services CurrentSince Jan 1, 2026 Accepting new patients
Sacred Heart Health Services CurrentSince Jan 1, 2026 Accepting new patients
Yankton Medical Clinic PC Current Accepting new patients
Yankton Medical Clinic PC Current Accepting new patients
Sacred Heart Health Services CurrentSince Jan 1, 2026 Accepting new patients
Yankton Medical Clinic PC Otolaryngology CurrentSince Sep 15, 2021 Accepting new patients
Yankton Medical Clinic PC CurrentSince Sep 15, 2021 Accepting new patients
Sacred Heart Health Services Past Accepting new patients

Locations

3901 W Norfolk Ave
Norfolk, NE 68701
Phone (402) 379-5555

3901 W Norfolk Ave
Ste C
Norfolk, NE 68701
Phone (402) 316-4606

704 N 3rd St
Plainview, NE 68769
Phone (402) 582-3434

101 S Plum St
Vermillion, SD 57069
Phone (605) 624-8643

1104 W 8th St
Yankton, SD 57078
Phone (605) 665-7841

2525 Fox Run Pkwy
Ste 100
Yankton, SD 57078
Phone (605) 260-0918

2525 Fox Run Pkwy
Ste 101
Yankton, SD 57078
Phone (605) 665-0062

501 Summit St
Yankton, SD 57078
Phone (605) 655-1201

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1609221563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 W 8TH ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570783306",
            "telephone_number": "605-665-7841",
            "fax_number": "605-665-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 FOX RUN PKWY STE 101",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570785371",
            "telephone_number": "605-665-0062",
            "fax_number": "605-665-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-28",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "SD",
            "license": "12813",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NE",
            "license": "33769",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rnicholas@direct.yanktonmedicalclinic.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2525 Fox Run Pkwy Ste 101",
            "city": "Yankton",
            "state": "SD",
            "country_code": "US",
            "postal_code": "570785371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Yankton, SD

Sources for this page

Verify at the official NPI Registry.