GUY WILLIAM NICOLETTE (MD) – Sports Medicine (Family Medicine) Physician, NPI 1104885524
Sports Medicine (Family Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,706 FAMILY PRACTICE in TX
Provider Addresses for GUY WILLIAM NICOLETTE (MD)
UC BERKELEY UNIV HEALTH SVCS
2222 BANCROFT WAY
BERKELEY, CA 947204300
Phone: (510) 643-8569
Fax: (510) 643-5079
Type: Mailing
8300 FLOYD CURL DR
SAN ANTONIO, TX 782293931
Phone: (210) 450-9300
Type: Mailing
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 $100.
Total Amount is formed as General ($100) + Research ($0) + Ownership ($0) = $100.
Last reported payment date: 2023-04-13 • Largest payer in this snapshot: NeuroLogica Corporation, a subsidiary of Samsung Electronics Co., Ltd. ($100).
Total Amount
$100
General + Research + Ownership
Payments
1
Total payment records
General Amount
$100
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-04-13
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2023-06-14
PECOS data refreshed: 2026-05-27
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230614002692 | I | Family Practice | TX | TBD |
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.
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 94720)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TX | |
| - | TX | |
| - | TX | |
| Internal Medicine, Hospitalist | TX | |
| - | TX | |
| - | TX | |
| Internal Medicine, Hematology/Oncology | TX | |
| - | TX | |
| Hematology/Oncology, Medical Oncology | TX | |
| - | TX |
Reviews
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