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NICOLE CANON MD
NPI 1104288398
Allergy & Immunology in Vacaville, CA

Active since March 25, 2016PECOS EnrolledAccepts Medicare Assignment
1 QUALITY DR, VACAVILLE, CA 95688(707) 624-2020 Get Directions Write a Review

NPPES record last updated: April 9, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 9, 2024, Jul 20, 2021, Apr 8, 2019 and 1 more (4 updates tracked since 2016).

About Nicole Canon Md NPPES

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

NICOLE CANON MD (NPI 1104288398) is an individual allergy & immunology provider in Vacaville, California, licensed in California (A192664) and active in the NPI registry since March 2016. She is enrolled in Medicare PECOS, maintains 5 additional practice locations, and is a graduate of University Of Texas Medical School At San Antonio (2016).

NPPES Registry Identity

NPI1104288398
Entity TypeIndividualFemale
Primary Taxonomy207K00000X
Provider Legal NameNICOLE CANONCredential: MD
Location Address1 QUALITY DRVacaville, CA 95688-9494
Mailing Address1 Quality DrVacaville, CA 95688-9494 · (707) 624-2020
Phone(707) 624-2020
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical School At San AntonioGraduated 2016
Enumeration DateMarch 25, 2016
Last NPPES UpdateApril 9, 20244 updates tracked since enumeration
NPPES CertifiedApril 9, 2024
✔ NPI 1104288398 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAllergy & ImmunologyAllopathic & Osteopathic Physicians
Taxonomy Code207K00000X
Licenses✔ Licensed in CA · A192664✔ Licensed in TX · T2131
Definition
An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1 QUALITY DR, Vacaville, CA 95688
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Secondary Practice Locations 5

Location 11400 Jackson St # K624Denver, CO 80206-2761 · Phone (877) 225-5654
Location 2106 Vision Park BlvdShenandoah, TX 77384-3000 · Phone (713) 442-1800
Location 315655 Cypress Wood Medical Dr Ste 100Houston, TX 77014-1487 · Phone (713) 442-1700
Location 413105 Wortham Center DrHouston, TX 77065-5611 · Phone (713) 442-4000
Location 57200 Cambridge St, 9th floorHouston, TX 77030-4202 · Phone (713) 798-6151

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicole Canon Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42552697
PECOS Enrollment IDI20240125002889
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Nicole Canon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Permanente Medical Group Inc
23 mi
Internal Medicine
975 SERENO DRIVE
Vallejo, CA 94589
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1336222397 (707) 651-1000
Kelsey-Seybold Medical Group, PLLC
1,632 mi
Multi-Specialty
2727 W HOLCOMBE BLVD
Houston, TX 77025
  • Reassigned Medicare billing, Texas enrollment
  • 1,649 clinicians in this Medicare group
NPI 1013915255 (713) 442-0000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

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

DONALD BRADNER WARD CRNA
Nurse Anesthetist, Certified Registered
1 QUALITY DR
VACAVILLE, CA 95688
Solano County (707) 624-4207
MS. ELAINE GARDNER PT
Physical Therapist
1 QUALITY DR
VACAVILLE, CA 95688
Solano County (707) 624-4000
SAMANTHA LYNN TORRES-RAMONDO
Respiratory Therapist, Registered
1 QUALITY DR
VACAVILLE, CA 95688
Solano County (707) 624-1850
WES R WILTSE DO
Physical Medicine & Rehabilitation
1 QUALITY DR, B36
VACAVILLE, CA 95688
Solano County (707) 684-3840
MRS. NATALIA FELDMAN OTR/L
Occupational Therapist
1 QUALITY DR
VACAVILLE, CA 95688
Solano County (707) 624-4000
DR. TERAH HENNICK MD
Orthopaedic Surgery
1 QUALITY DR
VACAVILLE, CA 95688
Solano County (707) 624-4000
ANKUR NITIN KAPADIA MD
Family Medicine
1 QUALITY DR
VACAVILLE, CA 95688
Solano County (707) 624-4000
KAISER PERMANENTE
Clinic/Center (Adult Mental Health)
1 QUALITY DR
VACAVILLE, CA 95688
Solano County (707) 624-2600

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 Nicole Canon's NPI number?

The NPI number for Nicole Canon is 1104288398. It was assigned to this individual provider in the NPPES registry on March 25, 2016.

Where is Nicole Canon located?

Nicole Canon practices at 1 Quality Dr, Vacaville, CA 95688. The listed phone number is (707) 624-2020.

What is Nicole Canon's specialty?

The primary specialty registered for this NPI is Allergy & Immunology with taxonomy code 207K00000X.

Is Nicole Canon enrolled in Medicare?

Yes. Nicole Canon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Nicole Canon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Canon reassigns Medicare benefits to 2 organizations: Permanente Medical Group Inc (Vallejo, CA) and Kelsey-Seybold Medical Group, PLLC (Houston, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicole Canon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nicole Canon was last updated on April 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.