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MICHAEL NICKSIC MD
NPI 1346779907
Student in an Organized Health Care Education/Training Program in Charlottesville, VA

Active since June 07, 2017PECOS EnrolledAccepts Medicare Assignment
95.31/100
CMS Quality Rating
1215 LEE ST BOX 800377, CHARLOTTESVILLE, VA 22908(434) 924-9400(434) 243-6731 Get Directions Write a Review

NPPES record last updated: June 15, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 15, 2024, Aug 25, 2023, Jun 7, 2017 (3 updates tracked since 2017).

About Michael Nicksic Md NPPES

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

MICHAEL NICKSIC MD (NPI 1346779907) is an individual student in an organized health care education/training program in Charlottesville, Virginia, licensed in Virginia (0116038831) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS, is affiliated with Wellmont Bristol Regional Medical Center, and maintains a secondary practice location in Columbus.

NPPES Registry Identity

NPI1346779907
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMICHAEL NICKSICCredential: MD
Location Address1215 LEE ST BOX 800377Charlottesville, VA 22908-0816
Mailing Address1215 Lee St Box 800377Charlottesville, VA 22908-0816 · (434) 924-9400 · Fax (434) 243-6731
Phone(434) 924-9400
Fax(434) 243-6731
Sole ProprietorNo
Medical School CMSUniversity Of Louisville School Of MedicineGraduated 2018
Enumeration DateJune 7, 2017
Last NPPES UpdateJune 15, 20243 updates tracked since enumeration
NPPES CertifiedJune 15, 2024
✔ NPI 1346779907 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in VA · 0116038831
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedRadiology · Diagnostic RadiologyTaxonomy 2085R0202X · License 35.140897 (OH)
1215 LEE ST BOX 800377, Charlottesville, VA 22908
Open in Google Maps ↗

Secondary Practice Location 1

Location 1395 W 12th AveColumbus, OH 43210-1267 · Phone (614) 293-8315 · Fax (614) 293-6935

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

Michael Nicksic 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 ID446673347
PECOS Enrollment IDI20250318003334, I20250327000229
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 Reassignment

Medicare enrollment records show Michael Nicksic reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Blue Ridge Radiology, P.C.
229 mi
Diagnostic Radiology
933 HIGHWAY 126
Bristol, TN 37620
  • Reassigned Medicare billing, Tennessee and Virginia enrollments
  • Medicare enrollment name: Blue Ridge Radiology PC
  • 89 clinicians in this Medicare group
NPI 1881687689 (423) 968-1144

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

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Wellmont Bristol Regional Medical Center

Acute Care Hospitals · Bristol, TN
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number440012
LocationOne Medical Park BlvdBristol, TN 37620 · Sullivan County
Emergency services Birthing friendly

Wellmont Holston Valley Medical Center

Acute Care Hospitals · Kingsport, TN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440017
Location130 West Ravine RoadKingsport, TN 37662 · Sullivan County
Emergency services

Greeneville Community Hospital

Acute Care Hospitals · Greeneville, TN
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440050
Location1420 Tusculum BoulevardGreeneville, TN 37745 · Greene County
Emergency services Birthing friendly

Johnson City Medical Center

Acute Care Hospitals · Johnson City, TN
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440063
Location400 N State Of Franklin RdJohnson City, TN 37604 · Washington County
Emergency services Birthing friendly

Smyth County Community Hospital

Acute Care Hospitals · Marion, VA
OwnershipVoluntary non-profit - Private
CMS Certification Number490038
Location245 Medical Park DriveMarion, VA 24354 · Smyth County
Emergency services

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.

95.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality76.58
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 9

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

CALVIN LE
Radiology (Vascular & Interventional Radiology)
1215 LEE ST BOX 800377
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-9400
DR. ROBERT SHE MD
Student in an Organized Health Care Education/Training Program
1215 LEE ST BOX 800377
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-9400
DR. FRANKLIN IHEANACHO MD
Student in an Organized Health Care Education/Training Program
1215 LEE ST BOX 800377
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-9400
TAYLOR SEELAND MD
Student in an Organized Health Care Education/Training Program
1215 LEE ST BOX 800377
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-9400
DR. JINEET PATEL M.D.
Student in an Organized Health Care Education/Training Program
1215 LEE ST BOX 800377
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-9400
SOMIAH E ALMEKY MD
Student in an Organized Health Care Education/Training Program
1215 LEE ST BOX 800377
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-9400
ERNEST WEIDER WANG
Student in an Organized Health Care Education/Training Program
1215 LEE ST BOX 800377
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-9400
DR. ERIC JAMES FROMKE MD
Student in an Organized Health Care Education/Training Program
1215 LEE ST BOX 800377
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-9400

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 Michael Nicksic's NPI number?

The NPI number for Michael Nicksic is 1346779907. It was assigned to this individual provider in the NPPES registry on June 7, 2017.

Where is Michael Nicksic located?

Michael Nicksic practices at 1215 Lee St Box 800377, Charlottesville, VA 22908. The listed phone number is (434) 924-9400.

What is Michael Nicksic's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Michael Nicksic enrolled in Medicare?

Yes. Michael Nicksic 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 organization bills Medicare for Michael Nicksic's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Nicksic reassigns Medicare benefits to Blue Ridge Radiology, P.C. (Bristol, TN). The 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 Michael Nicksic's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Michael Nicksic affiliated with any hospitals?

According to CMS data, Michael Nicksic is affiliated with Wellmont Bristol Regional Medical Center, Wellmont Holston Valley Medical Center, Greeneville Community Hospital, Johnson City Medical Center and Smyth County Community Hospital.

When was this NPI record last updated?

The NPPES record for Michael Nicksic was last updated on June 15, 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.