DR. NICHOLAS JOHN COAN (DO) – Family Medicine Physician, NPI 1104355197

DR. NICHOLAS JOHN COAN (DO) is a healthcare provider. based in Bayonne, New Jersey. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. 25MB10794700 (NJ). The NPI Number for DR. NICHOLAS JOHN COAN (DO) is 1104355197

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
DR. NICHOLAS JOHN COAN (DO)
NPI
1104355197
Phone
Not provided
Address
29 E 29TH ST
Enumeration Date
5 June 2017
Last Update Date
13 June 2025

Doctor Profile

Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
8563467816
Graduation Year
2017 (9 years ago)
PAC ID
7618393935
Group Practice PAC ID
5294648457
Professional Enrollment ID
I20200818001546
Address ID
NJ080840000ST18XXXRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness85
Years active:9State licenses:1Digital endpointsOther names

2,515 FAMILY PRACTICE in NJ

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Provider Addresses for DR. NICHOLAS JOHN COAN (DO)

  • Bayonne Medical Center, 29, East 29th Street, Bayonne, Hudson County, New Jersey, 07002, United States

    BAYONNE, NJ 070024654

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2020-08-18

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200818001546IFamily PracticeNJTBD

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 07002)

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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: 5294648457View full group profile
NameSpecialtyState
-PA
General Practice, Family PracticeGA
Nurse PractitionerNJ
Emergency MedicineNJ
Emergency MedicinePA
Emergency MedicinePA
Emergency MedicineNJ
Emergency MedicineNJ
Emergency MedicineNJ
Emergency MedicinePA

Reviews

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Frequently asked questions

Can I use this page to confirm DR. NICHOLAS JOHN COAN (DO)'s NPI?
Yes. DR. NICHOLAS JOHN COAN (DO) is listed with NPI 1104355197 in the public NPI dataset.
Is DR. NICHOLAS JOHN COAN (DO) listed as active for patients and plans?
The listing shows DR. NICHOLAS JOHN COAN (DO) as active in the NPI system.
What taxonomy line describes DR. NICHOLAS JOHN COAN (DO)?
For research purposes, treat DR. NICHOLAS JOHN COAN (DO) as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is DR. NICHOLAS JOHN COAN (DO) based?
DR. NICHOLAS JOHN COAN (DO) is tied to Bayonne, New Jersey in the data we show; additional addresses may exist on the full record.
Is the information about DR. NICHOLAS JOHN COAN (DO) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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