DR. NICHOLAS GILLIAM (DO) – Student in an Organized Health Care Education/Training Program, NPI 1255960357
Student in an Organized Health Care Education/Training Program
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
1,953 PSYCHIATRY in FL
Provider Addresses for DR. NICHOLAS GILLIAM (DO)
2995 DREW ST FL 2
CLEARWATER, FL 337593012
Phone: (727) 315-7496
Type: Mailing
200 AVENUE F NE
WINTER HAVEN, FL 338814131
Phone: (800) 229-2273
Type: Location
SUMMA HEALTH/PSYCHIATRY 525 E. MARKET STREET
AKRON, OH 44304
Phone: (330) 379-5083
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $30.
Total Amount is formed as General ($30) + Research ($0) + Ownership ($0) = $30.
Last reported payment date: 2023-05-16 • Largest payer in this snapshot: ITI, Inc. ($30).
Total Amount
$30
General + Research + Ownership
Payments
2
Total payment records
General Amount
$30
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ITI, Inc. | $30 |
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: 2024-08-01
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 |
|---|---|---|---|---|
| I20240801004280 | I | Psychiatry | FL | 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 33759)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | FL | |
| P S Y C H I A T R Y | FL | |
| P S Y C H I A T R Y | FL | |
| P S Y C H I A T R Y | PR | |
| - | FL | |
| Clinical Psychologist | FL | |
| P S Y C H I A T R Y | FL | |
| P S Y C H I A T R Y | FL | |
| P S Y C H I A T R Y | FL | |
| P S Y C H I A T R Y | TN |
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