Active NPI
Michael Edward Nickas
- Urology Physician
- Castro Valley, CA
National Provider Identifier
1770572760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- G70673
- 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, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 13 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G70673 | CA | MD | Urology Physician |
Interoperability endpoints
- mnickas142019@hisp.ehr.sutterhealth.org
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Highland General Hospital
- General Acute Care Hospital
- Oakland, CA
- NPI 1083815872
-
dba Highland General Hospital
- General Acute Care Hospital
- Oakland, CA
- NPI 1396764353
-
dba Highland General Hospital
- General Acute Care Hospital
- Oakland, CA
- NPI 1700087590
-
dba Eden Medical Center
- General Acute Care Hospital
- Castro Valley, CA
- NPI 1063812907
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; 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.