NICHOLAS WENDELL WICKERSHAM M.D.
NPI 1396867222
Radiology - Diagnostic Radiology in Boulder, CO

Active since April 03, 2007PECOS EnrolledAccepts Medicare Assignment
1100 BALSAM AVE, BOULDER, CO 80304(303) 532-3500 Get Directions Write a Review

NPPES record last updated: March 15, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 15, 2021, Mar 22, 2016 (2 updates tracked since 2016).

About Nicholas Wendell Wickersham M.d. NPPES

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

NICHOLAS WENDELL WICKERSHAM M.D. (NPI 1396867222) is an individual diagnostic radiology provider in Boulder, Colorado, licensed in Colorado (47842) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS, maintains a secondary practice location in Boulder, and is a graduate of University Of Washington School Of Medicine (2003).

NPPES Registry Identity

NPI1396867222
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameNICHOLAS WENDELL WICKERSHAMCredential: M.D.
Location Address1100 BALSAM AVEBoulder, CO 80304-3404
Mailing Address42 Garden CtrBroomfield, CO 80020-1730 · (303) 465-0401 · Fax (303) 438-1351
Sole ProprietorYes
Medical School CMSUniversity Of Washington School Of MedicineGraduated 2003
Enumeration DateApril 3, 2007
Last NPPES UpdateMarch 15, 20212 updates tracked since enumeration
NPPES CertifiedMarch 15, 2021
NPI 1396867222 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License Licensed in CO · 47842
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
1100 BALSAM AVE, Boulder, CO 80304

Secondary Practice Location 1

Location 14747 Arapahoe AveBoulder, CO 80303-1131 · Phone (877) 465-0012

Other Identifiers 1

Medicaid07101759CO

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Nicholas Wendell Wickersham M.d. 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 ID6305919622
PECOS Enrollment IDI20090724000109
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.

Areas of Expertise CMS Part B claims 69

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.

X-ray of chest, 1 view 71045
A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.
435 services349 patients
Dxa bone density measurement of hip, pelvis, spine including spine fracture assessment 77085
A DXA bone density measurement is a non-invasive scan that helps assess the strength of your bones, specifically in the hip, pelvis, and spine areas. It can detect early signs of osteoporosis and evaluate fracture risk. This test uses low-dose X-rays for accurate results.
303 services303 patients
Screening 3d breast mammography 77063
Screening 3D breast mammography is a procedure that uses low-dose X-rays to create detailed images of the breast. This allows for early detection of any unusual changes or growths. It's a non-invasive, outpatient procedure that typically takes about 30 minutes.
293 services293 patients
Screening mammography 77067
Screening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.
293 services293 patients
Interpretation of trabecular bone score (tbs) and report on fracture risk 77092
The Trabecular Bone Score (TBS) is a tool that helps evaluate your bone health. It looks at the texture of your bones, which can indicate their strength. The results, combined with other tests, help assess your risk of future fractures.
292 services292 patients
X-ray of chest, 2 views 71046
A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.
230 services225 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80304 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
$89.43 typical visit price
range $58.06 – $174.82
Typical copayment $22.35 (range $14.51 – $43.70)
Most-billed visit code 99203
Established Patient
$72.20 typical visit price
range $18.88 – $142.79
Typical copayment $18.05 (range $4.72 – $35.69)
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.

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.

Reported Quality Measures

Appropriate Follow-up Imaging for Incidental Abdominal Lesions
Percentage of final reports for abdominal imaging studies for asymptomatic patients aged 18 years and older with one or more of the following noted incidentally with follow_up imaging recommended: - Liver lesion =< 0.5 cm - Cystic kidney lesion < 1.0 cm -…
Lower rates are better for this measure.
0%85 patients
Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques
Percentage of final reports for patients aged 18 years and older undergoing CT with documentation that one or more of the following dose reduction techniques were used: - Automated exposure control - Adjustment of the mA and/or kV according to patient size -…
100%591 patients
Radiology: Reminder System for Screening Mammograms
Percentage of patients undergoing a screening mammogram whose information is entered into a reminder system with a target due date for the next mammogram
100%319 patients
Radiology: Stenosis Measurement in Carotid Imaging Reports
Percentage of final reports for carotid imaging studies (neck magnetic resonance angiography [MRA], neck computed tomography angiography [CTA], neck duplex ultrasound, carotid angiogram) performed that include direct or indirect reference to measurements of…
100%68 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

Pathology (Clinical Pathology/Laboratory Medicine)
1100 BALSAM AVE
BOULDER, CO 80304
Pathology (Anatomic Pathology & Clinical Pathology)
1100 BALSAM AVE
BOULDER, CO 80304
Occupational Therapist
1100 BALSAM AVE
BOULDER, CO 80304
Emergency Medicine
1100 BALSAM AVE
BOULDER, CO 80304
Anesthesiology
1100 BALSAM AVE
BOULDER, CO 80304
Emergency Medicine
1100 BALSAM AVE
BOULDER, CO 80304
Emergency Medicine
1100 BALSAM AVE
BOULDER, CO 80304
Physician Assistant
1100 BALSAM AVE
BOULDER, CO 80304

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 Nicholas Wickersham's NPI number?

The NPI number for Nicholas Wickersham is 1396867222. It was assigned to this individual provider in the NPPES registry on April 3, 2007.

Where is Nicholas Wickersham located?

Nicholas Wickersham practices at 1100 Balsam Ave, Boulder, CO 80304. The listed phone number is (303) 532-3500.

What is Nicholas Wickersham's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Nicholas Wickersham enrolled in Medicare?

Yes. Nicholas Wickersham 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.

When was this NPI record last updated?

The NPPES record for Nicholas Wickersham was last updated on March 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.