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HOLLY LYNN NIKODYM FNP
NPI 1083306542
Nurse Practitioner - Family in Upland, CA

Active since May 23, 2023PECOS Enrolled
901 SAN BERNARDINO RD STE 300, UPLAND, CA 91786(909) 579-6753 Get Directions Write a Review

NPPES record last updated: May 23, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Holly Lynn Nikodym Fnp NPPES

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

HOLLY LYNN NIKODYM FNP (NPI 1083306542) is an individual family provider in Upland, California, licensed in California (95025306) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083306542
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameHOLLY LYNN NIKODYMCredential: FNP
Location Address901 SAN BERNARDINO RD STE 300Upland, CA 91786-7299
Mailing Address901 San Bernardino Rd Ste 300Upland, CA 91786-7299 · (909) 579-6753
Phone(909) 579-6753
Sole ProprietorNo
Enumeration DateMay 23, 2023
NPPES CertifiedMay 23, 2023
✔ NPI 1083306542 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95025306
901 SAN BERNARDINO RD STE 300, Upland, CA 91786
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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)

Holly Lynn Nikodym Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 91786 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
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
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.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELITE MEDICAL GROUP GP
Hospitalist
901 SAN BERNARDINO RD STE 300
UPLAND, CA 91786
San Bernardino County (918) 809-2411
SAN ANTONIO REGIONAL MEDICAL GROUP, INC.
Clinic/Center (Primary Care)
901 SAN BERNARDINO RD STE 300
UPLAND, CA 91786
San Bernardino County (909) 920-4801
KEVIN H YANG FNP-C
Nurse Practitioner (Family)
901 SAN BERNARDINO RD STE 300
UPLAND, CA 91786
San Bernardino County (909) 579-6753

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 Holly Nikodym's NPI number?

The NPI number for Holly Nikodym is 1083306542. It was assigned to this individual provider in the NPPES registry on May 23, 2023.

Where is Holly Nikodym located?

Holly Nikodym practices at 901 San Bernardino Rd Ste 300, Upland, CA 91786. The listed phone number is (909) 579-6753.

What is Holly Nikodym's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Holly Nikodym enrolled in Medicare?

Yes. Holly Nikodym is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Holly Nikodym was last updated on May 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.