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DR. MICHAEL DAVID NICKERSON JR. M.D.
NPI 1790927671
Anesthesiology in Fort Liberty, NC

Active since March 24, 2009PECOS EnrolledAccepts Medicare Assignment
84.44/100
CMS Quality Rating
2817 ROCK MERRITT AVE STOP A, FORT LIBERTY, NC 28310(910) 908-2318 Get Directions Write a Review

NPPES record last updated: January 1, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 1, 2025, Dec 27, 2024, Nov 7, 2024 and 1 more (4 updates tracked since 2022).

About Dr. Michael David Nickerson Jr. M.d. NPPES

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

DR. MICHAEL DAVID NICKERSON JR. M.D. (NPI 1790927671) is an individual anesthesiology provider in Fort Liberty, North Carolina, licensed in North Carolina (2019-02595) and active in the NPI registry since March 2009. He is enrolled in Medicare PECOS, is affiliated with Southeastern Regional Medical Center, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1790927671
Entity TypeIndividualMale
Primary Taxonomy207L00000X
Provider Legal NameDR. MICHAEL DAVID NICKERSON JR.Credential: M.D.
Location Address2817 ROCK MERRITT AVE STOP AFort Liberty, NC 28310-7394
Mailing Address2817 Rock Merritt Ave Stop AFort Liberty, NC 28310-0001 · (910) 907-8707
Phone(910) 908-2318
Sole ProprietorYes
Medical School CMSOtherGraduated 2008
Enumeration DateMarch 24, 2009
Last NPPES UpdateJanuary 1, 20254 updates tracked since enumeration
NPPES CertifiedJanuary 1, 2025
✔ NPI 1790927671 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
Licenses✔ Licensed in NC · 2019-02595✔ Licensed in TX · Q4227✔ Licensed in VA · 0101246915
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
2817 ROCK MERRITT AVE STOP A, Fort Liberty, NC 28310
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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

Dr. Michael David Nickerson Jr. 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 ID2264811322
PECOS Enrollment IDI20220620001463
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

3

Medicare enrollment records show Michael Nickerson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

American Anesthesiology Of North Carolina, PLLC
61 mi
Pain Medicine
110 CAPCOM AVE STE 200
Wake Forest, NC 27587
  • Reassigned Medicare billing, North Carolina enrollment
  • 300 clinicians in this Medicare group
NPI 1942248547 (984) 215-6931
Southeast Anesthesiology Consultants, PLLC
78 mi
Anesthesiology
600 GREEN VALLEY ROAD, SUITE 304
Greensboro, NC 27408
  • Reassigned Medicare billing, North Carolina enrollment
  • 223 clinicians in this Medicare group
NPI 1861702425 (336) 282-4840
Medstream Anesthesia PLLC
1,023 mi
Anesthesiology
2221 LAKESIDE BLVD STE 600
Richardson, TX 75082
  • Reassigned Medicare billing, North Carolina enrollment
  • 493 clinicians in this Medicare group
NPI 1649616160 (828) 210-9386

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

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

Southeastern Regional Medical Center

Acute Care Hospitals · Lumberton, NC
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340050
Location300 W 27 St PO Box 1408Lumberton, NC 28359 · Robeson County
Emergency services Birthing friendly

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.

84.44/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality88.33
Improvement Activities40
Cost69.53

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.

MOLLY CUNARD
Ophthalmology
2817 ROCK MERRITT AVE STOP A, ATTN: CREDENTIALS OFFICE
FORT BRAGG, NC 28310
Cumberland County (910) 907-7830
CAROLINE MICHAELA PYZDROWSKI PT
Physical Therapist
2817 ROCK MERRITT AVE STOP A
FORT BRAGG, NC 28310
Cumberland County (630) 947-9375
JUSTINE J MAJERES
Psychologist
2817 ROCK MERRITT AVE STOP A
FORT BRAGG, NC 28310
Cumberland County (910) 907-8922
WILLIAM RICHARDSON
Physician Assistant
2817 ROCK MERRITT AVE STOP A
FORT BRAGG, NC 28310
Cumberland County (910) 432-2997
MR. MICHAEL B. WOODY PT
Physical Therapist
2817 ROCK MERRITT AVE STOP A
FORT BRAGG, NC 28310
Cumberland County (910) 907-6069
DESTINY R REYNOLDS FNPC
Nurse Practitioner (Family)
2817 ROCK MERRITT AVE STOP A
FORT BRAGG, NC 28310
Cumberland County (910) 908-6257
JOSHUA MIN HO RODIN PA-C
Physician Assistant
2817 ROCK MERRITT AVE STOP A
FORT BRAGG, NC 28310
Cumberland County (910) 987-5756
DAVID BRADLEY WILLIS PA-C, MPAS
Physician Assistant
2817 ROCK MERRITT AVE STOP A
FORT BRAGG, NC 28310
Cumberland County (910) 643-1923

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 Nickerson's NPI number?

The NPI number for Michael Nickerson is 1790927671. It was assigned to this individual provider in the NPPES registry on March 24, 2009.

Where is Michael Nickerson located?

Michael Nickerson practices at 2817 Rock Merritt Ave Stop A, Fort Liberty, NC 28310. The listed phone number is (910) 908-2318.

What is Michael Nickerson's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Michael Nickerson enrolled in Medicare?

Yes. Michael Nickerson 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 organizations bill Medicare for Michael Nickerson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Nickerson reassigns Medicare benefits to 3 organizations: American Anesthesiology Of North Carolina, PLLC (Wake Forest, NC), Southeast Anesthesiology Consultants, PLLC (Greensboro, NC) and Medstream Anesthesia PLLC (Richardson, TX). 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 Michael Nickerson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Michael Nickerson affiliated with any hospitals?

According to CMS data, Michael Nickerson is affiliated with Southeastern Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Michael Nickerson was last updated on January 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.