Shay Nicholas, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

47159-020 Issued in WI

Practice address

744 S Webster Ave
Green Bay, WI 54301-3505

Phone

(920) 433-3500

Fax

(920) 433-7932

NPI assigned

Nov 25, 2005

Sex

Female

Sole proprietor

Yes

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 WI, CA2 enrollments

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 2

Specialty

Emergency Medicine

Education

University of Connecticut School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northbay Physicians Surgery Center, LLCGroup PAC ID 0042122244, 336 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northbay Medical Center Hospital, Fairfield, CA, CCN 050367

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Northbay Healthcare Group

  • General Acute Care Hospital
  • Fairfield, CA
  • NPI 1821147786
  Medicare reassignment Care Compare group NPD
• Emergency Physician Associates of Wisconsin SC

  • Emergency Medicine Physician
  • Marinette, WI
  • NPI 1396119426
  Medicare reassignment NPD
• Solano Gateway Medical Group Inc

  • Emergency Medicine Physician
  • Fairfield, CA
  • NPI 1952344293
  Medicare reassignment NPD
• Northbay Healthcare Group

  • Multi-Specialty Clinic/Center
  • Vacaville, CA
  • NPI 1760534713
  NPD
• Green Bay Emergency Medicine Services S.C.

  • Emergency Medicine Physician
  • Green Bay, WI
  • NPI 1366424111
  NPD (past)
• Waterbury Hospital

  • General Acute Care Hospital
  • Waterbury, CT
  • NPI 1184615114
  NPD (past)
• Xue Feng Wang, M.D., LTD.

  • Specialist
  • Reno, NV
  • NPI 1730418674
  NPD (past)

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

• Northbay Healthcare Group

  • General Acute Care Hospital
  • Fairfield, CA
  • NPI 1821147786
  Care Compare affiliation

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

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398297600000",
    "number": "1700869526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-423-4100",
            "fax_number": "414-423-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-433-3500",
            "fax_number": "920-433-7932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "SHAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-25",
        "last_updated": "2014-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "47159-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34554700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Graham Newman, D.D.S., M.S.
• Nexora Medical Transport LLC
• Jimmy Khang Nguyen, PA-C
• Thuy Nguyen, DMD
• Vannhu Nguyen, M.D.
• Amanda Nichols, APNP
• Katelyn Ellen Nichols, PHARMD
• Lindsey Catherine Nichols
• Morgan Nicholson, RDH
• Joel William Nickel, DC

• Emergency Medicine Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; 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.