Individual provider Active NPI

Michael Sinclair Nitikman, DO

  • Emergency Medicine Physician
  • Norfolk, VA
National Provider Identifier
1730762899
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS022991 Issued in PA
Practice address
1775 Forrestal Dr BLDG New
Norfolk, VA 23551-6202
Phone
(757) 836-1552
NPI assigned
May 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OT020707 PA
Emergency Medicine Physician 207P00000X OS022991 PA Primary

Addresses

Primary practice location

1775 Forrestal Dr BLDG New
Norfolk, VA 23551-6202

Mailing address

5162 Briarwood Dr
Macungie, PA 18062-9727
Phone (562) 477-7906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NC2 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

Enrollment IDStateProvider typePAC IDDetails
I20231011001711 PA Practitioner - Emergency Medicine 4486063294 Reassigns benefits to 2 organizations
I20251104003602 NC Practitioner - Emergency Medicine 4486063294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Philadelphia College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tarheel Emergency Group, PLLCGroup PAC ID 6709268576, 40 clinicians

Practice addresses (Care Compare)

317 Western Blvd
Jacksonville, NC 28546-6338
Phone (910) 577-2345

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS022991PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Associates of Pennsylvania, PC Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Tarheel Emergency Group, PLLC Emergency Medicine CurrentSince Oct 1, 2025 Accepting new patients
Lehigh Valley Physician Group Emergency Medicine Current Accepting new patients
Lehigh Valley Physician Group Emergency Medicine CurrentSince Aug 22, 2023 Accepting new patients
Lehigh Valley Physician Group CurrentSince Aug 22, 2023 Accepting new patients

Locations

317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240

2100 Mack Blvd
Allentown, PA 18103
Phone (484) 224-1892

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

300 Highland Ave
Hanover, PA 17331
Phone (717) 316-3711

700 E Broad St
Hazleton, PA 18201
Phone (570) 501-4000

700 E Norwegian St
Pottsville, PA 17901
Phone (570) 621-4000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1730762899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5162 BRIARWOOD DR",
            "city": "MACUNGIE",
            "state": "PA",
            "postal_code": "180629727",
            "telephone_number": "562-477-7906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 FORRESTAL DR BLDG NEW",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235516202",
            "telephone_number": "757-836-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NITIKMAN",
        "first_name": "MICHAEL",
        "middle_name": "SINCLAIR",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-05",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OT020707",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS022991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.