David L Nichols, PHD is a medicare enrolled "Psychologist - Counseling" provider in Sturtevant, Wisconsin. He went to State University Of New York At Buffalo School Of Medicine and graduated in 1980 and has 44 years of diverse experience with area of expertise as Clinical Psychologist. He is a member of the group practice Psychiatric Services Of Racine Llp and his current practice location is
8700 Durand Ave Ste 600, Sturtevant, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(262) 635-5520.
David L Nichols is licensed to practice in Wisconsin (license number 943-057) 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 1063409852.
Healthcare Provider's Profile
| Full Name | David L Nichols |
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| Gender | Male |
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| Speciality | Clinical Psychologist |
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| Experience | 44 Years |
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| Location | 8700 Durand Ave Ste 600, Sturtevant, Wisconsin |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- David L Nichols attended and graduated from State University Of New York At Buffalo School Of Medicine in 1980
NPI Data:
- NPI Number: 1063409852
- Provider Enumeration Date: 10/05/2005
- Last Update Date: 03/27/2018
Medicare PECOS Information:
- PECOS PAC ID: 3173529617
- Enrollment ID: I20061006000077
Medical Identifiers
Medical identifiers for David L Nichols such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1063409852 | NPI | - | NPPES |
| 39027600 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TC1900X | Psychologist - Counseling | 943-057 (Wisconsin) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Psychiatric Services Of Racine Llp | 1658377148 | 5 |
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. David L Nichols allows following entities to bill medicare on his behalf.
| Entity Name | Psychiatric Services Of Racine Llp |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1699791988
PECOS PAC ID: 1658377148
Enrollment ID: O20061005000400 |
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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. David L Nichols 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 |
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David L Nichols, PHD
8700 Durand Ave Ste 600,
Sturtevant, WI 53177-2096
Ph: (262) 635-5520 | David L Nichols, PHD
8700 Durand Ave Ste 600,
Sturtevant, WI 53177-2096
Ph: (262) 635-5520 |
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