STEPHEN A NICKISCH (M.D.) – Obstetrics & Gynecology Physician, NPI 1578596615
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
142 OBSTETRICS/GYNECOLOGY in MT
Provider Addresses for STEPHEN A NICKISCH (M.D.)
Dan Proctor Drive, Saint Marys, Camden County, Georgia, 31558, United States
SUITE 1200
SAINT MARYS, GA 315583894
Phone: (912) 540-6750
Fax: (912) 540-6773
Type: Mailing
500 W Broadway St Fl 4Bb
Missoula, MT 598024008
Phone: (406) 329-5828
Type: Location
2060 DAN PROCTOR DR STE 1200
SAINT MARYS, GA 315583895
Phone: (912) 540-6750
Fax: (912) 540-6773
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $229.
Total Amount is formed as General ($229) + Research ($0) + Ownership ($0) = $229.
Last reported payment date: 2024-06-12 • Largest payer in this snapshot: Inari Medical, Inc. ($229).
Total Amount
$229
General + Research + Ownership
Payments
3
Total payment records
General Amount
$229
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Inari Medical, Inc. | $229 |
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: 2022-07-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| I20031125000794 | I | Obstetrics/Gynecology | MT | TBD |
| I20130702000576 | I | Obstetrics/Gynecology | GA | TBD |
| I20161112000168 | I | Obstetrics/Gynecology | FL | TBD |
| I20220727001732 | I | Obstetrics/Gynecology | WY | 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 31558)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | HI | |
| O B S T E T R I C S/ G Y N E C O L O G Y | ID | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| - | GA | |
| - | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| - | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA |
Reviews
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