Timothy Charles Paik-Nicely

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

G44510 Issued in CA

Practice address

2505 Lucas St
Ste B
Eureka, CA 95501-3340

Phone

(707) 601-9767

Fax

(707) 601-9746

NPI assigned

Jun 29, 2005

Last updated

Sep 20, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Timothy Charles Nicely Professional name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23253/brand/1/csg/1/fhir/r4
• Direct secure messaging: timothy.paiknicelymd.p1@direct.ppnorcal.nextgenshare.com
• Direct secure messaging: timothy.piaknicely.p1@direct.rrhc.nextgenshare.com
• Direct secure messaging: tpaiknicely312540@direct.ochin.org
• Direct secure messaging: tpaiknicely725492@direct.ochin.org
• Direct secure messaging: tpaiknicely813591@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment NPD
• K'Ima:W Medical Center

  • Clinic/Center
  • Hoopa, CA
  • NPI 1306904222
  Medicare reassignment NPD
• Open Door Community Health Centers

  dba Del Norte Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Crescent City, CA
  • NPI 1497840656
  Medicare reassignment NPD
• United Indian Health Services, Inc.

  • Primary Care Clinic/Center
  • Arcata, CA
  • NPI 1497751572
  Medicare reassignment NPD
• With Open Arms Reproductive Health Care Services Inc

  • Obstetrics & Gynecology Physician
  • Eureka, CA
  • NPI 1336601707
  NPD Authorized official
• With Open Arms / Reproductive Health Care Services LLC

  • Family Medicine Physician
  • Eureka, CA
  • NPI 1114476413
  Authorized official Same address or phone
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • Tulare, CA
  • NPI 1306327846
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• K'Ima:W Medical Center

  • Clinic/Center
  • Hoopa, CA
  • NPI 1861661365
  NPD
• Open Door Community Health Centers

  dba Humboldt Open Door Clinic

  • Federally Qualified Health Center (FQHC)
  • Arcata, CA
  • NPI 1255435533
  NPD
• Open Door Community Health Centers

  dba McKinleyville Community Health Center

  • Federally Qualified Health Center (FQHC)
  • McKinleyville, CA
  • NPI 1598858169
  NPD
• Open Door Community Health Centers

  dba Willow Creek Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Willow Creek, CA
  • NPI 1730330739
  NPD

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

{
    "created_epoch": "1120003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1760489389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 LUCAS ST",
            "address_2": "STE B",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013340",
            "telephone_number": "707-601-9767",
            "fax_number": "707-601-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 LUCAS ST",
            "address_2": "STE B",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013340",
            "telephone_number": "707-601-9767",
            "fax_number": "707-601-9746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAIK-NICELY",
        "first_name": "TIMOTHY",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-29",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G44510",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G44510",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G445100",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIMOTHY",
            "last_name": "NICELY",
            "middle_name": "CHARLES",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Destiny Ruth Pagan
• Gantuya Nadmidtseren Page, FNP-C
• Keely Shaye Page
• Nicole Page
• Shekhar S. Pai, M.D.
• Elisabeth Pajara
• Claudia Renee Paliaga, MFT
• Grayson Palmer, DDS
• Michael Anthony Palmer, M.D.
• Robin Lorraine Palmer, OTR/L

• Emergency Medicine Physician in Eureka, CA
• Providers in Eureka, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.