Jason Niksch

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A74019 Issued in CA

Practice address

1950 Alameda de Las Pulgas
San Mateo, CA 94403-1222

Phone

(650) 573-3571

NPI assigned

Jan 23, 2007

Last updated

Jan 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Psychiatry

Education

Indiana University School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

County of San MateoGroup PAC ID 9032023171, 316 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• County of San Mateo

  dba San Mateo Medical Center

  • Multi-Specialty Clinic/Center
  • San Mateo, CA
  • NPI 1679642326
  Medicare reassignment Care Compare group NPD
• Comprehensive Psychiatric Services, a Medical Group

  • Psychiatry Physician
  • Walnut Creek, CA
  • NPI 1184785834
  Medicare reassignment NPD
• County of San Mateo

  dba Shasta

  • Community/Behavioral Health Agency
  • Redwood City, CA
  • NPI 1528432481
  NPD
• San Mateo County

  dba Service Connect

  • Community/Behavioral Health Agency
  • San Carlos, CA
  • NPI 1770862344
  NPD
• County of San Mateo

  dba San Mateo Medical Center

  • Clinic/Center
  • San Mateo, CA
  • NPI 1942226014
  NPD (past)
• Magellan Health Services of Arizona, Inc

  • Case Management Agency
  • Gilbert, AZ
  • NPI 1194965145
  NPD (past)
• Vo of Arizona, Inc.

  dba ValueOptions Laboratory Services

  • Clinical Medical Laboratory
  • Glendale, AZ
  • NPI 1447458682
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1609921667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 ALAMEDA DE LAS PULGAS",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031222",
            "telephone_number": "650-573-3571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 ALAMEDA DE LAS PULGAS",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031222",
            "telephone_number": "650-573-3571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKSCH",
        "first_name": "JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A74019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A740190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Leslie Ivette Nieves, MFT
• Nightingale Birth, Inc.
• Damon Nim
• Elena Nimon, PA-C
• Nina Bratcher, Licensed Clinical Social Worker, PC (Bay Area Therapy Services)
• Doris Nishimoto, D.D.S.
• Nitxies, LLC

• Psychiatry Physician in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.