Individual provider Active NPI

Matthew Steven Nicholson, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Augusta, GA
National Provider Identifier
1962639823
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
72981 Issued in GA
Practice address
1120 15TH St
Augusta, GA 30912-2643
Phone
(706) 721-8623
Fax
(706) 721-1459
NPI assigned
Jun 18, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 072981 GA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 72981 GA Primary

Addresses

Primary practice location

1120 15TH St
Augusta, GA 30912-2643

Mailing address

PO Box 1705
Augusta, GA 30903-1705
Phone (706) 774-7263

Other practice location 1

4321 University Pkwy Ste 101
Evans, GA 30809-3093
Phone (706) 854-3410

Other practice location 2

3905 Due West Rd NW
Marietta, GA 30064-1019
Phone (866) 389-2727

Other identifiers 1

IdentifierTypeStateIssuer
318962MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20170830003586 GA Practitioner - Internal MedicinePractitioner - Endocrinology 0749445229 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Endocrinology
Education
Medical College of Georgia School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-8623

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

587 Furys Ferry Rd
Martinez, GA 30907-9059
Phone (706) 721-8623

989 Saint Sebastian Way
Augusta, GA 30912-0004
Phone (706) 721-2171

Hospital & facility affiliations

  • Wellstar MCG Health, Affiliated With Med Col Hospital, Augusta, GA, CCN 110034
  • Piedmont Augusta Hospital Hospital, Augusta, GA, CCN 110028

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72981GAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Au Medical Associates Inc CurrentSince Feb 1, 2021 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Sep 1, 2023 Accepting new patients
Au Medical Associates Inc CurrentSince Feb 1, 2021 Accepting new patients
Baptist Easley Internal Medicine Past Accepting new patients
Prisma Health University Medical Group PastSince Jul 1, 2013 Accepting new patients

Locations

1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

4321 University Pkwy
Ste 101
Evans, GA 30809
Phone (706) 774-7400

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Organizations & group practices 6

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 2

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": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1962639823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1705",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309031705",
            "telephone_number": "706-774-7263",
            "fax_number": "706-774-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309122643",
            "telephone_number": "706-721-8623",
            "fax_number": "706-721-1459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4321 University Pkwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Evans",
            "state": "GA",
            "postal_code": "308093093",
            "country_code": "US",
            "telephone_number": "706-854-3410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3905 Due West Rd NW",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300641019",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "MATTHEW",
        "middle_name": "STEVEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-18",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "072981",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "GA",
            "license": "72981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318962",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.