David Dean Nisley, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA 12965 Issued in CA

Practice address

1441 Florida Ave
Neurosurgery PA
Modesto, CA 95350-4405

Phone

(209) 578-1211

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

Yes

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 CA

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, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

David a Olson MD a Professional CorporationGroup PAC ID 7618278052, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• David a. Olson, MD, a Professional Corporation

  • Medical Specialty Clinic/Center
  • Oakdale, CA
  • NPI 1891167821
  Medicare reassignment Care Compare group
• Sutter North Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Yuba City, CA
  • NPI 1144251521
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1710044888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504404",
            "telephone_number": "209-576-3601",
            "fax_number": "209-576-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVE",
            "address_2": "NEUROSURGERY PA",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504405",
            "telephone_number": "209-578-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISLEY",
        "first_name": "DAVID",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA 12965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nirmal S Rai MD Inc
• Nirvana Drug and Alcohol
• Nirvana Drug and Alcohol Institute
• Nirvana Drug and Alcohol Treatment Institute
• Rissa Rahmani Putri Nirwandar
• Megan Nix
• Eloh Nfounju Njikam-McGee
• Devon Njoroge
• Onyema G Nkwocha, ADMINISTRATOR
• Shannon Nobles

• Surgical Physician Assistant in Modesto, CA
• Providers in Modesto, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; 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.