Ethan Aolphus Nicholls, MD in Fremont, CA

Ethan Aolphus Nicholls, MD is a medicare enrolled "Anesthesiology" physician in Fremont, California. He graduated from medical school in 1988 and has 36 years of diverse experience with area of expertise as Anesthesiology. He is a member of the group practice Sutter Bay Medical Foundation and his current practice location is 3200 Kearney St, Fremont, California. You can reach out to his office (for appointments etc.) via phone at (510) 490-1222.

Ethan Aolphus Nicholls is licensed to practice in California (license number G67915) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1801805106.

Contact Information

	Ethan Aolphus Nicholls, MD
	3200 Kearney St, Fremont, CA 94538-2299
	(510) 490-1222
	Not Available

Map and Direction

Physician's Profile

Full Name	Ethan Aolphus Nicholls
Gender	Male
Speciality	Anesthesiology
Experience	36 Years
Location	3200 Kearney St, Fremont, California
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Ethan Aolphus Nicholls graduated from medical school in 1988

NPI Data:

NPI Number: 1801805106
Provider Enumeration Date: 08/05/2006
Last Update Date: 05/29/2020

Medicare PECOS Information:

PECOS PAC ID: 4789625187
Enrollment ID: I20050516000956

Medical Identifiers

Medical identifiers for Ethan Aolphus Nicholls such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1801805106	NPI	-	NPPES
00G679150	Medicaid	CA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207L00000X	Anesthesiology	G67915 (California)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Sutter Bay Medical Foundation	4284538778	2995

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ethan Aolphus Nicholls allows following entities to bill medicare on his behalf.

Entity Name	Sutter Bay Medical Foundation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1013950807 PECOS PAC ID: 4284538778 Enrollment ID: O20031125000909

Entity Name	Sutter Bay Medical Foundation
Entity Type	Part B Supplier - Ambulatory Surgical Center
Entity Identifiers	NPI Number: 1982845186 PECOS PAC ID: 4284538778 Enrollment ID: O20090501000247

Entity Name	Sutter Bay Medical Foundation
Entity Type	Part B Supplier - Ambulatory Surgical Center
Entity Identifiers	NPI Number: 1104067115 PECOS PAC ID: 4284538778 Enrollment ID: O20090501000456

Entity Name	Sutter Bay Medical Foundation
Entity Type	Part B Supplier - Ambulatory Surgical Center
Entity Identifiers	NPI Number: 1497996524 PECOS PAC ID: 4284538778 Enrollment ID: O20090506000097

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ethan Aolphus Nicholls is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Ethan Aolphus Nicholls, MD 325 Distel Cir, Los Altos, CA 94022-1408 Ph: (510) 490-1222	Ethan Aolphus Nicholls, MD 3200 Kearney St, Fremont, CA 94538-2299 Ph: (510) 490-1222

Reviews and Comments

Anesthesiology Doctors in Fremont, CA

Shurea A. Wilson, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 39400 Paseo Padre Pkwy, Fremont, CA 94538 Phone: 510-795-3000
Joan June Chen, Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2000 Mowry Ave, Fremont, CA 94538 Phone: 510-797-1111
Surinder Sandhu, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 2299 Mowry Ave, Fremont, CA 94538 Phone: 510-791-5374
Dr. Abhilasha Solanki, M.D Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 39400 Paseo Padre Pkwy, Fremont, CA 94538 Phone: 510-248-3000
Brian E Smith, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2000 Mowry Ave, Fremont, CA 94538 Phone: 510-797-1111
Stephen R Shuput, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 43314 Banda Ter, Fremont, CA 94539 Phone: 800-991-6704 Fax: 408-444-8845
Ann Marie Mallat, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 3200 Kearney St., Fremont, CA 94538 Phone: 510-490-1222

Ethan Aolphus Nicholls, MD - Medicare Anesthesiology in Fremont, CA