Nichole Renee Matlick, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A105016 Issued in CA

Practice address

510 Superior Ave Ste 200D
Newport Beach, CA 92663

Phone

(949) 791-3001

NPI assigned

Sep 29, 2007

Last updated

Oct 11, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Nichole Renee Morgan Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hoag Clinic

  • Primary Care Clinic/Center
  • Newport Beach, CA
  • NPI 1942799523
  Medicare reassignment NPD
• Hoag Hospital

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1689864365
  NPD (past)
• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300
  NPD (past)
• Mission Hospital Regional Medical Center

  dba Providence Mission Hospital

  • Rehabilitation Hospital
  • Mission Viejo, CA
  • NPI 1003956913
  NPD (past)
• Pediatric Inpatient Specialists PC

  • Hospitalist Physician
  • Santa Maria, CA
  • NPI 1972829224

  Pediatrics

  NPD (past)
• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  NPD (past)
• Saddleback Memorial Medical Center

  • Rehabilitation Hospital Unit
  • Laguna Hills, CA
  • NPI 1114967114
  NPD (past)
• Mission Hospital, Inc.

  dba Mission Regional Medical Center

  • General Acute Care Hospital
  • Mission, TX
  • NPI 1205833985
  NPD (past)

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

{
    "created_epoch": "1191024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1982891396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 SUPERIOR AVE STE 200D",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633664",
            "telephone_number": "949-791-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 SUPERIOR AVE STE 200D",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92663",
            "telephone_number": "949-791-3001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 E Church St",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934545906",
            "country_code": "US",
            "telephone_number": "805-739-3600",
            "fax_number": "805-739-3075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATLICK",
        "first_name": "NICHOLE",
        "middle_name": "RENEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-29",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A105016",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A105016",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL BOARD LICENSE",
            "identifier": "A105016",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "MORGAN",
            "middle_name": "RENEE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristin Masukawa, MD
• Heather Mather, M.A., LMFT
• Joanna Mathews, R.D.
• Kushagra Mathur
• Kathryn Nichole Matlack, DC
• Matrix Rehabilitation, Inc. (Select Physical Therapy)
• Matrix Rehabilitation, Inc. (Select Physical Therapy)
• Tyson Kazuo Matsumoto, D.P.T.
• David Alan Matsuyama, O.D.
• Matthew Houston Clark MD Inc (The Clark Center for Urogynecology)

• Pediatrics Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.