Mark W Nickels, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME152102 Issued in FL

Practice address

12271 US Highway 301 N
Parrish, FL 34219-8410

Phone

(941) 776-4050

NPI assigned

May 30, 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

Medicare fee-for-service enrollment

Enrolled in FL

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

Internal Medicine

Education

Louisiana State University School of Medicine in New Orleans, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCR Health IncGroup PAC ID 7214847995, 132 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 and National Provider Directory roles.

• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000
  Medicare reassignment Care Compare group NPD
• Walsh Family Medicine LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Bradenton, FL
  • NPI 1356826770
  Medicare reassignment NPD
• MCR Health, Inc.

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1679520837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RIVERFRONT BLVD STE 710",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058812",
            "telephone_number": "941-776-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12271 US HIGHWAY 301 N",
            "city": "PARRISH",
            "state": "FL",
            "postal_code": "342198410",
            "telephone_number": "941-776-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELS",
        "first_name": "MARK",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2023-11-07",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME152102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonia Michelle Murray, PHARMD
• Margaret Nash, LCSW
• National Vision Inc
• Dawn C Neaverth
• Julie Nejame, PSY.D.
• Brandon Novatko, DO
• Jean Mary O'Connor, ARNP
• Janet Olmeda Rivera
• On Q Home Care Services LLC
• Andrea Orleanski

• Internal Medicine Physician in Parrish, FL
• Providers in Parrish, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.