NICOLE M. GULLICKSON M.D.
NPI 1174783211
Family Medicine in Fargo, ND

Q: What is Nicole Gullickson's NPI number?

The NPI number for Nicole Gullickson is 1174783211. It was assigned to this individual provider in the NPPES registry on June 12, 2008.

Q: What is Nicole Gullickson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Gullickson was last updated on January 19, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since June 12, 2008PECOS Enrolled

85.54/100

CMS Quality Rating

2400 32ND AVE S, FARGO, ND 58103(701) 234-8800 Get Directions Write a Review

NPPES record last updated: January 19, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Nicole M. Gullickson M.d. NPPES

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

NICOLE M. GULLICKSON M.D. (NPI 1174783211) is an individual family medicine provider in Fargo, North Dakota, licensed in North Dakota (11974) and active in the NPI registry since June 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174783211

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameNICOLE M. GULLICKSONCredential: M.D.

Location Address2400 32ND AVE SFargo, ND 58103-5800

Mailing Address2400 32nd Ave SFargo, ND 58103-5800

Phone(701) 234-8800

Sole ProprietorNo

Enumeration DateJune 12, 2008

Last NPPES UpdateJanuary 19, 2012

✔ NPI 1174783211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in ND · 11974✔ Licensed in IA · R-8325

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2400 32ND AVE S, Fargo, ND 58103

Open in Google Maps ↗

Other Identifiers 3

Medicaid16268ND

Medicare PINN717126ND

Medicare PINN717125ND

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole M. Gullickson M.d. 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.

Medicare Billing Reassignments

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

University North Dakota

76 mi

Student Health

MCCANNEL HALL ROOM 100, 2891 2ND AVENUE NORTH STOP 9038
Grand Forks, ND 58202

Reassigned Medicare billing, North Dakota enrollment
Medicare enrollment name: University Of North Dakota
48 clinicians in this Medicare group

NPI 1922067305 (701) 777-4500

West River Health Services

264 mi

Physical Therapy

401 MILLIONAIRE AVE
Mott, ND 58646

Reassigned Medicare billing, North Dakota enrollment
Also billed through NPI 1518089499 (North Dakota)
28 clinicians in this Medicare group

NPI 1902526411 (701) 567-4561

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

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

32 services20 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

21 services14 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

18 services18 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

18 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 58103 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

$85.71 typical visit price

range $55.75 – $168.12

Typical copayment $21.42 (range $13.93 – $42.03)

Most-billed visit code 99203

Established Patient

$98.29 typical visit price

range $18.11 – $137.65

Typical copayment $24.57 (range $4.52 – $34.41)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

85.54/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

78.91

Promoting Interoperability

Improvement Activities

Cost

62.68

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.

JASON C MYRMOE MD

Family Medicine