WILLIAM DAVID NICKELL (PA-C) – Surgical Physician Assistant, NPI 1376826925
Surgical Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
5,032 PHYSICIAN ASSISTANT in OH
Provider Addresses for WILLIAM DAVID NICKELL (PA-C)
100 MEDICAL CENTER DR
SPRINGFIELD, OH 455042687
Phone: (937) 523-9885
Fax: (937) 523-9887
Type: Mailing
3533 SOUTHERN BLVD
SUITE 5650
KETTERING, OH 454291264
Phone: (937) 294-3611
Fax: (937) 294-9010
Type: Mailing
3533 SOUTHERN BLVD STE 5650
KETTERING, OH 454291263
Phone: (937) 294-3611
Fax: (937) 294-9010
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $142.
Total Amount is formed as General ($142) + Research ($0) + Ownership ($0) = $142.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Medical Device Business Services, Inc. ($59).
Total Amount
$142
General + Research + Ownership
Payments
3
Total payment records
General Amount
$142
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
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: 2025-10-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20120120000537 | I | Physician Assistant | OH | TBD |
| I20251014003839 | I | Physician Assistant | ND | 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 45504)
Loading plans...
Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | OH | 33533 | Heart artery bypass to repair one artery | 22 | 22 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | ND | |
| Nurse Practitioner | ND | |
| - | ND | |
| - | ND | |
| P S Y C H I A T R Y | ND | |
| - | PA | |
| N E P H R O L O G Y | SD | |
| U R O L O G Y | MI | |
| Nurse Practitioner | ND | |
| H O S P I T A L I S T | ND |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.