Melanie Nichols, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

58078 Issued in CA

Practice address

4002 Vista Way
Oceanside, CA 92056-4506

Phone

(760) 724-8411

NPI assigned

May 29, 2020

Sex

Female

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: melanie.nichols@3856.securemail.prognocis.com

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.

• Team Physicians of Southern California Medical Group, Inc.

  • Emergency Medicine Physician
  • Oceanside, CA
  • NPI 1225499015
  Medicare reassignment

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1891319430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 VISTA WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564506",
            "telephone_number": "760-724-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 VISTA WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564506",
            "telephone_number": "760-724-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "MELANIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Nguyen
• Nima Niakishargh, DPT
• Edward D. Niavez, L.V.N.
• Sandra Lynn Nibbelink Ahearn, NP
• Nicole B Nicholas
• Michelle Dimond Nichols, MS, RDN
• Ray Nicholson
• Leah J Nielsen IV
• Madelene Nielsen, RN
• Martin M. Nielsen, M.D.

• Physician Assistant in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; 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.