Russell Nicoll, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2565 Issued in AZ

Practice address

6501 E Greenway Pkwy
Scottsdale, AZ 85254-2065

Phone

(480) 948-3314

Fax

(480) 948-3588

NPI assigned

May 23, 2006

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 AZ

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

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Hyperbarics LLCGroup PAC ID 2264409697, 6 clinicians

Gila Health ResourcesGroup PAC ID 1254327216, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Chandler Regional Medical Center Hospital, Chandler, AZ, CCN 030036

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: russell.nicoll.1@33093.direct.athenahealth.com

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.

• Gila Health Resources

  • Family Medicine Physician
  • Morenci, AZ
  • NPI 1497740187
  Medicare reassignment Care Compare group
• Valley Hyperbarics LLC

  • Personal Emergency Response Attendant
  • Chandler, AZ
  • NPI 1760439244
  Medicare reassignment Care Compare group
• Chandler Emergency Medical Group, LLC

  • Emergency Medicine Physician
  • Chandler, AZ
  • NPI 1104871961
  Medicare reassignment
• Tec Emergency Physicians of Arizona, LLC

  • Emergency Care Clinic/Center
  • Gilbert, AZ
  • NPI 1245772870
  Medicare reassignment
• Scottsdale Emergency Associates, LTD.

  • Emergency Medicine Physician
  • Scottsdale, AZ
  • NPI 1083671432

  Physician Assistant

  NPD
• Ucxtra Umbrella, LLC

  • Urgent Care Clinic/Center
  • Chandler, AZ
  • NPI 1518952365
  NPD (past)

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

• Dignity Community Care

  • General Acute Care Hospital
  • Chandler, AZ
  • NPI 1700910189
  Care Compare affiliation

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1619922341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 S CLEARVIEW AVE STE 100",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093378",
            "telephone_number": "480-988-9108",
            "fax_number": "480-813-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 E GREENWAY PKWY",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852542065",
            "telephone_number": "480-948-3314",
            "fax_number": "480-948-3588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLL",
        "first_name": "RUSSELL",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "711962",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Analecia C Nickel, MA,LMFT
• Wendy Elaine Nickerson, PSY.D.
• Alexander Joseph Nickolaou, PT,DPT
• Denise Nicoll, PT
• Jacob William Nicoll, OTR
• Kristin Marie Niedbala, OTR
• Dianna H Nielsen
• Meg Brianne Nielsen, OTD
• Jacquelyn Nielson, NMD
• Kordan Dee Nielson, OTR/L

• Physician Assistant in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; 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.