NPIMap

Individual provider Active NPI

Allison McNickle, M.D.

  • Surgical Critical Care Physician
  • Las Vegas, NV
National Provider Identifier
1689995441
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
16558 Issued in NV
Practice address
1707 W Charleston Blvd Ste 160
Las Vegas, NV 89102-2354
Phone
(702) 671-5150
NPI assigned
Jun 16, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 125-058-070 IL
Surgery Physician 208600000X 16558 NV
Surgical Critical Care PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0102X 16558 NV Primary

Addresses

Primary practice location

1707 W Charleston Blvd Ste 160
Las Vegas, NV 89102-2354

Mailing address

3016 W Charleston Blvd Ste 100
Las Vegas, NV 89102-1973
Phone (702) 780-7118

Other practice location 1

600 S Paulina St
Suite 527 AcFac
Chicago, IL 60612-3806
Phone (312) 942-5495

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171013002644 NV Practitioner - General Surgery 2466748041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Rush Medical College of Rush University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unlv MedicineGroup PAC ID 4183991458, 177 clinicians

Practice addresses (Care Compare)

1707 W Charleston Blvd
Las Vegas, NV 89102-2352

Hospital & facility affiliations

  • University Medical Center Hospital, Las Vegas, NV, CCN 290007

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-058-070ILMDSurgery Physician
16558NVMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine CurrentSince Aug 19, 2017 Accepting new patients
Unlv Medicine Multi-Specialty CurrentSince Aug 19, 2017 Accepting new patients
University Medical Center of Southern Nevada Multi-Specialty Past Accepting new patients
Rush University Medical Center Past Accepting new patients

Locations

1707 W Charleston Blvd
Ste 160
Las Vegas, NV 89102
Phone (702) 671-2201

1707 W Charleston Blvd
Ste 110
Las Vegas, NV 89102
Phone (702) 671-2300

1701 W Charleston Blvd
Ste 110
Las Vegas, NV 89102
Phone (702) 671-2395

2724 N Tenaya Way
Fl 2
Las Vegas, NV 89128
Phone (702) 939-8557

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

2410 Fire Mesa St
Ste 180
Las Vegas, NV 89128
Phone (702) 202-2700

3016 W Charleston Blvd
Ste 100
Las Vegas, NV 89102
Phone (702) 780-2315

1701 W Charleston Blvd
Ste 490
Las Vegas, NV 89102
Phone (702) 671-2273

Organizations & group practices 4

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.

Hospital & facility affiliations 12

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": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1689995441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 W CHARLESTON BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021973",
            "telephone_number": "702-780-7118",
            "fax_number": "702-895-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 W CHARLESTON BLVD STE 160",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022354",
            "telephone_number": "702-671-5150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 S Paulina St",
            "address_2": "Suite 527 AcFac",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123806",
            "country_code": "US",
            "telephone_number": "312-942-5495",
            "fax_number": "312-942-5727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCNICKLE",
        "first_name": "ALLISON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-16",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125-058-070",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "16558",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NV",
            "license": "16558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.