Active NPI
Matthew Steven Nicholson, M.D.
- Endocrinology, Diabetes & Metabolism Physician
- Augusta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- 72981
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 318962 | Medicaid | SC |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Medical College of Georgia School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
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
- Piedmont Augusta Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 72981 | GA | MD | Endocrinology, Diabetes & Metabolism Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Au Medical Associates Inc | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Au Medical Associates Inc | Current | Accepting new patients | |
| Baptist Easley | Internal Medicine | Past | Accepting new patients |
| Prisma Health University Medical Group | Past | 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.
-
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
- Multi-Specialty Clinic/Center
- Augusta, GA
- NPI 1841230620
-
- Durable Medical Equipment & Medical Supplies
- Augusta, GA
- NPI 1114574126
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
-
- Gynecology Physician
- Greer, SC
- NPI 1003619313
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Augusta, GA
- NPI 1437135902
-
- General Acute Care Hospital
- Augusta, GA
- NPI 1588665566
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.