DR. NICHOLAS AARON FETTMAN (MD) – Otolaryngology Physician, NPI 1003005109

DR. NICHOLAS AARON FETTMAN (MD) is a healthcare provider. based in Simi valley, California. specializing in OTOLARYNGOLOGY. They hold the professional credentials MD. They hold a License No. A116624 (CA). The NPI Number for DR. NICHOLAS AARON FETTMAN (MD) is 1003005109

Main info

Male
Sole Proprietor
20 Years Of Experience
Accepts Medicare Assignment
Name
DR. NICHOLAS AARON FETTMAN (MD)
NPI
1003005109
Phone
(805) 527-7320
Address
2876 SYCAMORE DR
Enumeration Date
15 October 2007
Last Update Date
27 November 2019

Doctor Profile

Medical School Name
OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
8059813770
Graduation Year
2006 (20 years ago)
PAC ID
7214106418
Group Practice PAC ID
9537155676
Professional Enrollment ID
I20110804000187
Address ID
CA930362102OX2361XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

1,365 OTOLARYNGOLOGY in CA

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Provider Addresses for DR. NICHOLAS AARON FETTMAN (MD)

  • Sycamore Drive, Simi Valley, Ventura County, California, 90363, United States

    SUITE 303

    SIMI VALLEY, CA 930651530

    Phone: (805) 527-7320

    Fax: (805) 527-2426

    Type: Mailing

  • 1700, North Rose Avenue, Oxnard, Ventura County, California, 93030, United States

    SUITE 460

    OXNARD, CA 930303790

    Phone: (805) 983-0395

    Fax: (805) 983-0463

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $27.

Total Amount is formed as General ($27) + Research ($0) + Ownership ($0) = $27.

Last reported payment date: 2024-11-11 • Largest payer in this snapshot: GENZYME CORPORATION ($27).

Total Amount

$27

General + Research + Ownership

Payments

1

Total payment records

General Amount

$27

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-11

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
GENZYME CORPORATION$27
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-08-04

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110804000187IOtolaryngologyCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 93065)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9537155676View full group profile
NameSpecialtyState
Family PracticeCA
-CA
Oral Surgery, NeurologyCA
Physician AssistantCA
-CA
Physician AssistantCA
Family PracticeCA
O B S T E T R I C S/ G Y N E C O L O G YCA
Certified Nurse Midwife (Cnm)CA
-CA

Reviews

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Frequently asked questions

Does DR. NICHOLAS AARON FETTMAN (MD) have a public NPI I can cite?
Public records show DR. NICHOLAS AARON FETTMAN (MD) under NPI 1003005109.
Is DR. NICHOLAS AARON FETTMAN (MD)'s NPI status active today?
Active status means DR. NICHOLAS AARON FETTMAN (MD)'s NPI record is not deactivated in the public file.
What type of care does DR. NICHOLAS AARON FETTMAN (MD) provide?
DR. NICHOLAS AARON FETTMAN (MD)'s profile centers on Otolaryngology Physician. Clinical services aligned with this taxonomy classification.
What city is tied to DR. NICHOLAS AARON FETTMAN (MD)?
The directory associates DR. NICHOLAS AARON FETTMAN (MD) with Simi Valley, California. Check all listed addresses for suites or satellite offices.
Can I export DR. NICHOLAS AARON FETTMAN (MD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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