Benjamin Joseph Nichols, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A97389 Issued in CA

Practice address

1300 S Eliseo Dr
Suite 207
Greenbrae, CA 94904-2023

Phone

(415) 925-0550

Fax

(415) 925-9062

NPI assigned

Jul 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Dermatology

Education

University of Southern California Keck School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greenbrae Dermatology, a Medical CorporationGroup PAC ID 4789832908, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

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.

• Greenbrae Dermatology, a Medical Corporation

  • Dermatology Physician
  • Greenbrae, CA
  • NPI 1174898654
  Medicare reassignment Care Compare group NPD
• University of California SFGH Medical Group

  • Dermatology Physician
  • San Francisco, CA
  • NPI 1164497285
  Medicare reassignment NPD
• University of California SFGH Medical Group

  • Vascular Surgery Physician
  • San Francisco, CA
  • NPI 1033913959
  NPD
• David Harold Berman, M.D., a Medical Corporation

  • Internal Medicine Physician
  • Mill Valley, CA
  • NPI 1134393887
  NPD (past)
• Jamie L Macdougall MD

  • Medical Specialty Clinic/Center
  • Manhattan Beach, CA
  • NPI 1134389489

  Dermatology

  NPD (past)
• Malcolm Ke, M.D., a Professional Corporation

  • Dermatology Physician
  • Torrance, CA
  • NPI 1225350069
  NPD (past)
• Marin General Hospital

  • General Acute Care Hospital
  • Greenbrae, CA
  • NPI 1396725677
  NPD (past)
• Regents Univ of California UCSF

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1124439807
  NPD (past)

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507680000000",
    "number": "1790983237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 S ELISEO DR",
            "address_2": "SUITE 207",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042023",
            "telephone_number": "415-925-0550",
            "fax_number": "415-925-9062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S ELISEO DR",
            "address_2": "SUITE 207",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042023",
            "telephone_number": "415-925-0550",
            "fax_number": "415-925-9062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "BENJAMIN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-05",
        "last_updated": "2017-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A97389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elsa O NG, MFT
• Olivia NG, PHARM.D
• Bao C Nguyen, PHARMD
• Chau Nguyen
• Trang Thu Nguyen
• Lambert Owen Nichols, D.D.S.
• Laura O Nichols, D.D.S, M.S.
• Julie Ilene Nicholson, LMFT
• Nona M Cunningham MD Inc
• Marisela Marisa Noorhasan, M.D.

• Dermatology Physician in Greenbrae, CA
• Providers in Greenbrae, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2017; 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.