Bambi L. Nickelberry, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G46679 Issued in CA

Practice address

11486 Burbank Blvd
North Hollywood, CA 91601-2301

Phone

(818) 505-9991

Fax

(818) 505-1331

NPI assigned

Oct 23, 2006

Sex

Female

Sole proprietor

Yes

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

Family Practice

Education

R Franklin University of Med & Sci/Chicago Medical School, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ease & Comfort Home Health, Inc Home health agency, Valley Village, CA, CCN 053105

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.

• Bambi L Nickelberry MD Professional Corporation

  • Adult Medicine Physician
  • Inglewood, CA
  • NPI 1972772655
  Medicare reassignment NPD Authorized official
• Gardena Hospital LP

  • Institutional Pharmacy
  • Gardena, CA
  • NPI 1669491700
  NPD (past)
• Prime Healthcare Centinela, LLC

  • General Acute Care Hospital
  • Inglewood, CA
  • NPI 1336328244
  NPD (past)
• St Francis Medical Center

  • Long Term Care Hospital
  • Lynwood, CA
  • NPI 1346378270
  NPD (past)

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

• Ease & Comfort Home Health, Inc.

  • Home Health Agency
  • Glendale, CA
  • NPI 1063814671
  Care Compare affiliation

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1942383740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11486 BURBANK BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916012301",
            "telephone_number": "818-505-9991",
            "fax_number": "818-505-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11486 BURBANK BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916012301",
            "telephone_number": "818-505-9991",
            "fax_number": "818-505-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELBERRY",
        "first_name": "BAMBI",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G46679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NH Pharmcare Inc
• NH Pharmcare Inc
• NH Urgent Care Medical Group Inc
• NHVC Group Inc
• Leah Nichols
• Kelsey Irene Nicolas
• Nihal Makhyoun, PHD, MFT, Apa
• Nina Gray, DMD, Inc.
• Nital Labs Inc
• Patrick A Njaka, RPH

• Family Medicine Physician in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.