Leroy Nickles, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

236503 Issued in NY

Practice address

170 W 12TH St
Emergency Dept Administration
New York, NY 10011-8202

Phone

(212) 604-2590

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, NY, NJ, CT, MI5 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 5

Specialty

Emergency Medicine

Education

Pennsylvania State University College of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Physician Services of New Jersey,Professional AssociationGroup PAC ID 1052554177, 51 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lehigh Valley Hospital - Pocono Hospital, East Stroudsburg, PA, CCN 390201
• Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008

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.

• Emergency Physician Services of New Jersey,Professional Association

  • Emergency Medicine Physician
  • Mount Holly, NJ
  • NPI 1831539568
  Medicare reassignment Care Compare group NPD
• Emergency Physician Services of New York, P.C.

  • Emergency Medicine Physician
  • Poughkeepsie, NY
  • NPI 1093759847
  Medicare reassignment NPD
• Emergency Department Physicians, P.C.

  • Emergency Medicine Physician
  • Detroit, MI
  • NPI 1225083595
  Medicare reassignment NPD
• Emergency Physician Associates of North Jersey P C

  • Emergency Medicine Physician
  • Summit, NJ
  • NPI 1497783419
  Medicare reassignment NPD
• Emergency Physician Associates of Pennsylvania, PC

  • Emergency Medicine Physician
  • Hanover, PA
  • NPI 1619990900
  Medicare reassignment NPD
• Emergency Physician Associates of South Jersey P C

  • Emergency Medicine Physician
  • Voorhees, NJ
  • NPI 1215965231
  Medicare reassignment NPD
• Emergency Physicians of Connecticut PC

  • Emergency Medicine Physician
  • Waterbury, CT
  • NPI 1902278906
  Medicare reassignment NPD
• New Jersey Medical and Health Associates,LLC

  dba CarePoint Health Medical Group

  • Internal Medicine Physician
  • Hoboken, NJ
  • NPI 1558673582
  Medicare reassignment NPD
• Observation Emergency Physicians, P.C.

  • Emergency Medicine Physician
  • Detroit, MI
  • NPI 1497920524
  Medicare reassignment NPD
• CMC Radiological Services PC

  dba St Vincents Catholic Medical Center

  • Diagnostic Radiology Physician
  • Elmhurst, NY
  • NPI 1093851990
  NPD (past)
• CMC Radiological Services PC

  dba St Vincents Catholic Medical Center

  • Diagnostic Radiology Physician
  • Jamaica, NY
  • NPI 1285780502
  NPD (past)
• Emergency Medical Metro P C

  dba Emergency Medical Associates Metro

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1154376150
  NPD (past)

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

• Holy Name Hospital Regional Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Teaneck, NJ
  • NPI 1043389349

  Hospital

  Care Compare affiliation
• Holy Name Medical Center Inc.

  • General Acute Care Hospital
  • Teaneck, NJ
  • NPI 1104859131
  Care Compare affiliation
• Lehigh Valley Hospital Pocono

  • General Acute Care Hospital
  • East Stroudsburg, PA
  • NPI 1568459436
  Care Compare affiliation

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1710070412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 SAINT NICHOLAS AVE APT D8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100325273",
            "telephone_number": "212-491-8725",
            "fax_number": "212-491-8725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 W 12TH ST",
            "address_2": "EMERGENCY DEPT ADMINISTRATION",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118202",
            "telephone_number": "212-604-2590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKLES",
        "first_name": "LEROY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD425081",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301511279",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "236503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nickjax LLC (LearningRx)
• Nickjax,LLC (LearningRx)
• Stephen Lawrence Nickl, D.O., M.S.
• Megan Nicklay, M.A.T.
• Kali Nickles
• Katy Anne Nickolaus, PA-C
• Cecilia E.W. Nicol, MD
• Martin Haynes Nicol Sr., PA-C
• Alice Helena Nicola
• Mona Nicolae, M.D.

• Emergency Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.