MICHAEL NICKSIC MD NPI 1346779907

NPI Information

  • NPI: 1346779907
  • Provider Name: MICHAEL NICKSIC, MD
  • Classification: Student in an Organized Health Care Education/Training Program - 390200000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1215 LEE ST BOX 800377
    CHARLOTTESVILLE, VA
    ZIP 22908
  • Phone: (434) 924-9400

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NPI Details

Michael Nicksic, MD is a student in an organized health care education training program in Charlottesville, VA with 7 years of experience. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Michael Nicksic, MD NPI is 1346779907. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE
Graduation Year:2018

The provider's business location address is:

1215 LEE ST BOX 800377
CHARLOTTESVILLE, VA
ZIP 22908-816
Phone: (434) 924-9400
Fax: (434) 243-6731

The NPI 1346779907 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/7/2017 and was last updated on 6/15/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic Radiology35.140897OHIONo
2390200000XStudent in an Organized Health Care Education/Training Program0116038831VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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