Individual provider Active NPI

Julianne Heidi Nichols, D.O.

  • Cardiovascular Disease Physician
  • Orchard Park, NY
National Provider Identifier
1851739460
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
299821 Issued in NY
Practice address
5959 Big Tree Rd
Orchard Park, NY 14127-2291
Phone
(716) 710-8266
Fax
(716) 710-8267
NPI assigned
Jun 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 299821 NY Primary

Addresses

Primary practice location

5959 Big Tree Rd
Orchard Park, NY 14127-2291

Mailing address

PO Box 488
Buffalo, NY 14240-0488
Phone (866) 853-9551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190724001805 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4082933395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

1091 Main St
Suite 301
Buffalo, NY 14209-2305
Phone (716) 362-0328

3898 Vineyard Dr
Dunkirk, NY 14048-3559
Phone (716) 710-8266

5959 Big Tree Rd
Orchard Park, NY 14127-2291
Phone (716) 882-0035

6009 S Transit Rd
Suite 300
Lockport, NY 14094-6307
Phone (716) 656-4077

705 Maple Rd
Williamsville, NY 14221-3291
Phone (716) 656-4077

Hospital & facility affiliations

  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
299821NYMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince Aug 1, 2019 Accepting new patients

Locations

3898 Vineyard Dr
Dunkirk, NY 14048
Phone (716) 363-1515

5959 Big Tree Rd
Ste 102
Orchard Park, NY 14127
Phone (716) 422-5677

5959 Big Tree Rd
Orchard Park, NY 14127
Phone (716) 260-1593

Interoperability endpoints

  • Direct secure messaging: jnichols@gppc.medentdirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 6

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": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1851739460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 488",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142400488",
            "telephone_number": "866-853-9551",
            "fax_number": "203-916-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 BIG TREE RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272291",
            "telephone_number": "716-710-8266",
            "fax_number": "716-710-8267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JULIANNE",
        "middle_name": "HEIDI",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-06",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "299821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.