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DINA NICKLAS
NPI 1003696600
Nurse Practitioner - Psychiatric/Mental Health in Deer Park, NY

Active since October 02, 2023PECOS Enrolled
84 WRIGHT AVE, DEER PARK, NY 11729(631) 241-5928 Get Directions Write a Review

NPPES record last updated: October 2, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dina Nicklas NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DINA NICKLAS (NPI 1003696600) is an individual psychiatric/mental health provider in Deer Park, New York, licensed in New York (405355) and active in the NPI registry since October 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1003696600
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameDINA NICKLAS
Location Address84 WRIGHT AVEDeer Park, NY 11729-2808
Mailing Address84 Wright AveDeer Park, NY 11729-2808 · (631) 241-5928
Phone(631) 241-5928
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateOctober 2, 2023
NPPES CertifiedOctober 2, 2023
✔ NPI 1003696600 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in NY · 405355
84 WRIGHT AVE, Deer Park, NY 11729
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dina Nicklas is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2365938677
PECOS Enrollment IDI20260106003145
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11729 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dina Nicklas's NPI number?

The NPI number for Dina Nicklas is 1003696600. It was assigned to this individual provider in the NPPES registry on October 2, 2023.

Where is Dina Nicklas located?

Dina Nicklas practices at 84 Wright Ave, Deer Park, NY 11729. The listed phone number is (631) 241-5928.

What is Dina Nicklas's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Dina Nicklas enrolled in Medicare?

Yes. Dina Nicklas is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Dina Nicklas was last updated on October 2, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.