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JOSHUA NICKERSON DO
NPI 1386091130
Psychiatry & Neurology - Psychiatry in Philadelphia, PA

Active since May 23, 2016PECOS Enrolled
4641 E ROOSEVELT BLVD, PHILADELPHIA, PA 19124(800) 889-0548 Get Directions Write a Review

NPPES record last updated: November 13, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 13, 2025, Jul 17, 2024, Nov 25, 2020 and 1 more (4 updates tracked since 2016).

About Joshua Nickerson Do NPPES

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

JOSHUA NICKERSON DO (NPI 1386091130) is an individual psychiatry provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (OS019814) and active in the NPI registry since May 2016. He is enrolled in Medicare PECOS, is affiliated with Presence Saint Joseph Hospital - Chicago, and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1386091130
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameJOSHUA NICKERSONCredential: DO
Location Address4641 E ROOSEVELT BLVDPhiladelphia, PA 19124-2343
Mailing Address100 N Academy AveDanville, PA 17822-9800 · (570) 271-6211
Phone(800) 889-0548
Sole ProprietorNo
Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 2016
Enumeration DateMay 23, 2016
Last NPPES UpdateNovember 13, 20254 updates tracked since enumeration
NPPES CertifiedNovember 13, 2025
✔ NPI 1386091130 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
Licenses✔ Licensed in PA · OS019814✔ Licensed in CO · DR.0068432✔ Licensed in IL · 036177295
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
4641 E ROOSEVELT BLVD, Philadelphia, PA 19124
Open in Google Maps ↗

Secondary Practice Locations 4

Location 1781 Far Hills DrNew Freedom, PA 17349-8447 · Phone (717) 812-2560
Location 28931 Huron StThornton, CO 80260-6806 · Phone (303) 853-3500 · Fax (303) 853-3702
Location 3100 N Academy AveDanville, PA 17822-9800 · Phone (570) 271-6211
Location 42900 N Lake Shore DrChicago, IL 60657-5640 · Phone (773) 665-4988

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Joshua Nickerson Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1951726207
PECOS Enrollment IDI20251125001547, I20260416000784
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

6

Medicare enrollment records show Joshua Nickerson reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Geisinger Clinic
74 mi
Family Medicine
529 TERRY REILEY WAY
Pottsville, PA 17901
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 4,429 clinicians in this Medicare group
NPI 1043261183 (570) 624-4444
Presence Healthcare Services
664 mi
Internal Medicine
9000 S STONY ISLAND AVE
Chicago, IL 60617
  • Reassigned Medicare billing, Illinois enrollment
  • 129 clinicians in this Medicare group
NPI 1922115864 (773) 731-0670
Bonaventure Medical Foundation, LLC
688 mi
Family Medicine
701 BIESTERFIELD RD UNIT 4D
Elk Grove Village, IL 60007
  • Reassigned Medicare billing, Illinois enrollment
  • 281 clinicians in this Medicare group
NPI 1588775647 (855) 692-6482
Ascension Medical Group-Southeast Wisconsin Inc
694 mi
Anesthesiology
2301 N LAKE DR
Milwaukee, WI 53211
  • Reassigned Medicare billing, Wisconsin enrollment
  • 1,343 clinicians in this Medicare group
NPI 1194473066 (414) 585-1000
Crossroads Turning Points Inc
1,481 mi
Methadone
3501 S MAIN ST
Lamar, CO 81052
  • Reassigned Medicare billing, Colorado enrollment
  • 18 clinicians in this Medicare group
NPI 1013210947 (719) 336-2600
Community Reach Center, Inc
1,580 mi
Community/Behavioral Health
8931 HURON ST
Thornton, CO 80260
  • Reassigned Medicare billing, Colorado enrollment
  • 96 clinicians in this Medicare group
NPI 1316906886 (303) 853-3500

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 2

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

Presence Saint Joseph Hospital - Chicago

Acute Care Hospitals · Chicago, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140224
Location2900 North Lake Shore DriveChicago, IL 60657 · Cook County
Emergency services Birthing friendly

St Alexius Medical Center

Acute Care Hospitals · Hoffman Estates, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140290
Location1555 N Barrington RdHoffman Estates, IL 60169 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19124 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
$180.99 typical visit price
range $59.88 – $180.99
Typical copayment $45.24 (range $14.97 – $45.24)
Most-billed visit code 99205
Established Patient
$74.47 typical visit price
range $19.30 – $147.29
Typical copayment $18.61 (range $4.82 – $36.82)
Most-billed visit code 99213
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.

ANTONINA DEVERUE
Counselor (Professional)
4641 E ROOSEVELT BLVD
PHILADELPHIA, PA 19124
Philadelphia County (215) 831-2962
SUNDEEP SINGH
Nurse Practitioner (Family)
4641 E ROOSEVELT BLVD
PHILADELPHIA, PA 19124
Philadelphia County (215) 831-4600
STEVENS WILLIAMS LMFT
Marriage & Family Therapist
4641 E ROOSEVELT BLVD
PHILADELPHIA, PA 19124
Philadelphia County (800) 889-0548

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 Joshua Nickerson's NPI number?

The NPI number for Joshua Nickerson is 1386091130. It was assigned to this individual provider in the NPPES registry on May 23, 2016.

Where is Joshua Nickerson located?

Joshua Nickerson practices at 4641 E Roosevelt Blvd, Philadelphia, PA 19124. The listed phone number is (800) 889-0548.

What is Joshua Nickerson's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Joshua Nickerson enrolled in Medicare?

Yes. Joshua Nickerson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Joshua Nickerson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Joshua Nickerson reassigns Medicare benefits to 6 organizations: Geisinger Clinic (Pottsville, PA), Presence Healthcare Services (Chicago, IL), Bonaventure Medical Foundation, LLC (Elk Grove Village, IL), Ascension Medical Group-Southeast Wisconsin Inc (Milwaukee, WI), Crossroads Turning Points Inc (Lamar, CO) and 1 more organization, listed in the Medicare section above. 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 Joshua Nickerson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Joshua Nickerson affiliated with any hospitals?

According to CMS data, Joshua Nickerson is affiliated with Presence Saint Joseph Hospital - Chicago and St Alexius Medical Center.

When was this NPI record last updated?

The NPPES record for Joshua Nickerson was last updated on November 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.