Individual provider Active NPI

Michael Edward Nickas

  • Urology Physician
  • Castro Valley, CA
National Provider Identifier
1770572760
Registry record updated Jul 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
G70673 Issued in CA
Practice address
20055 Lake Chabot Rd
#100
Castro Valley, CA 94546-5331
Phone
(510) 889-0270
Fax
(510) 889-8954
NPI assigned
Oct 21, 2005
Last updated
Jul 23, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X G70673 CA Primary

Addresses

Primary practice location

20055 Lake Chabot Rd
#100
Castro Valley, CA 94546-5331

Mailing address

20055 Lake Chabot Rd
#100
Castro Valley, CA 94546-5331
Phone (510) 889-0270

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060601000307 CA Practitioner - Urology 6002827284 Practice locations: Castro Valley, CA

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20055 Lake Chabot Rd
Suite 100
Castro Valley, CA 94546-5332
Phone (510) 889-0270

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
30 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G70673CAMDUrology Physician

Interoperability endpoints

  • Direct secure messaging: mnickas142019@hisp.ehr.sutterhealth.org

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1770572760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20055 LAKE CHABOT RD",
            "address_2": "#100",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465331",
            "telephone_number": "510-889-0270",
            "fax_number": "510-889-8954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20055 LAKE CHABOT RD",
            "address_2": "#100",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465331",
            "telephone_number": "510-889-0270",
            "fax_number": "510-889-8954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKAS",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "G70673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castro Valley, CA

Sources for this page

Verify at the official NPI Registry.