Nicole M Gullickson, MD - Medicare Family Medicine in Fargo, ND

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Nicole M Gullickson, MD is a medicare enrolled "Family Medicine" physician in Fargo, North Dakota. Her current practice location is 2400 32nd Ave S, Fargo, North Dakota. You can reach out to her office (for appointments etc.) via phone at (701) 234-8800.

Nicole M Gullickson is licensed to practice in North Dakota (license number 11974) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1174783211.

Contact Information

Nicole M Gullickson, MD
2400 32nd Ave S,
Fargo, ND 58103-5800
(701) 234-8800
Not Available

Map and Direction




Physician's Profile

Full NameNicole M Gullickson
GenderFemale
SpecialityFamily Medicine
Location2400 32nd Ave S, Fargo, North Dakota
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1174783211
  • Provider Enumeration Date: 06/12/2008
  • Last Update Date: 01/19/2012
  Medicare PECOS Information:
  • PECOS PAC ID: 9830238245
  • Enrollment ID: I20220825001331

Medical Identifiers

Medical identifiers for Nicole M Gullickson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1174783211NPI-NPPES
16268MedicaidND

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine R-8325 (Iowa)Secondary
207Q00000XFamily Medicine 11974 (North Dakota)Primary

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. Nicole M Gullickson allows following entities to bill medicare on her behalf.
Entity NameWest River Health Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1174606271
PECOS PAC ID: 0042127045
Enrollment ID: O20040128001023
Entity NameUniversity Of North Dakota
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1619905528
PECOS PAC ID: 2961395934
Enrollment ID: O20040204000241
Entity NameWest River Health Services
Entity TypePart A Provider - Critical Access Hospital
Entity IdentifiersNPI Number: 1588763247
PECOS PAC ID: 0042127045
Enrollment ID: O20100909000218

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. Nicole M Gullickson 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 AddressPractice Location Address
Nicole M Gullickson, MD
2400 32nd Ave S,
Fargo, ND 58103-5800

Ph: () -		Nicole M Gullickson, MD
2400 32nd Ave S,
Fargo, ND 58103-5800

Ph: (701) 234-8800

Reviews and Comments


Family Medicine Doctors in Fargo, ND

Dr. Michelle Renae Bradley, DO
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Practice Location: 4110 51st Ave S, Fargo, ND 58104
Phone: 701-364-3100    
Mary M. Nybakken, MD
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Medicare: Accepting Medicare Assignments
Practice Location: 5225 23rd Ave S, Fargo, ND 58104
Phone: 701-417-2575    Fax: 701-417-2535
Naomi Schuldt, DNP, APRN, FNP-C
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Medicare: Medicare Enrolled
Practice Location: 2400 32nd Ave S, Fargo, ND 58103
Phone: 701-234-2000    
Randall A Kenninger, MD
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Medicare: Accepting Medicare Assignments
Practice Location: 2400 32nd Ave S, Fargo, ND 58103
Phone: 701-234-8830    Fax: 702-234-8950
Hadeer Saleh Eltahan, MD
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Medicare: Not Enrolled in Medicare
Practice Location: 737 Broadway N, Fargo, ND 58102
Phone: 701-234-6076    Fax: 701-234-7230
Megan Harrington, FNP-C
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 801 Broadway N, Fargo, ND 58102
Phone: 701-234-2000    
Andrea Leigh Nellermoe Kaster, MD
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Medicare: Accepting Medicare Assignments
Practice Location: 801 Broadway N, Fargo, ND 58102
Phone: 701-234-2000    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.