GARY S. NICOLAISEN MD
NPI 1598849572
Urology in San Rafael, CA

Q: What is Gary Nicolaisen's NPI number?

The NPI number for Gary Nicolaisen is 1598849572. It was assigned to this individual provider in the NPPES registry on October 25, 2006.

Q: What is Gary Nicolaisen's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Gary Nicolaisen was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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 October 25, 2006

99 MONTECILLO RD, SAN RAFAEL, CA 94903(415) 444-2000 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Gary S. Nicolaisen Md NPPES

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

GARY S. NICOLAISEN MD (NPI 1598849572) is an individual urology provider in San Rafael, California, licensed in California (G42970) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1598849572

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameGARY S. NICOLAISENCredential: MD

Location Address99 MONTECILLO RDSan Rafael, CA 94903-3308

Mailing Address1800 Harrison St Fl 7Oakland, CA 94612-3429 · (510) 625-6262

Phone(415) 444-2000

Sole ProprietorNo

Enumeration DateOctober 25, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1598849572 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in CA · G42970

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

99 MONTECILLO RD, San Rafael, CA 94903

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Other Identifiers 3

Medicaid00G429700CA

Medicare UPINF14474

Medicare ID-Type Unspecified00G429700

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.

MS. MARTA JUDY FRIEDMAN LCSW, JD

Social Worker (Clinical)