DR. MICHAEL DAVID JR. NICKERSON (M.D.) – Anesthesiology Physician, NPI 1790927671
Anesthesiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,591 ANESTHESIOLOGY in TX
Provider Addresses for DR. MICHAEL DAVID JR. NICKERSON (M.D.)
3551 ROGER BROOKE DRIVE
SAN ANTONIO MEDICAL CENTER DEPARTMENT OF ANESTHESIA
JBSA FORT SAM HOUSTON, TX 78234
Phone: (210) 916-6874
Type: Location
2817 ROCK MERRITT AVE STOP A
FORT LIBERTY, NC 283100001
Phone: (910) 907-8707
Type: Mailing
Center for the Intrepid, 3551, Roger Brooke Drive, San Antonio, Bexar County, Texas, 78234, United States
SAN ANTONIO MEDICAL CENTER DEPARTMENT OF ANESTHESIA
JBSA FT SAM HOUSTON, TX 782344504
Phone:
Type: Mailing
6747 SURREY RD
FAYETTEVILLE, NC 283062592
Phone: (804) 761-0869
Type: Mailing
2817 REILLY ST
FORT BRAGG, NC 283107394
Phone: (910) 908-2318
Type: Location
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 $17.
Total Amount is formed as General ($17) + Research ($0) + Ownership ($0) = $17.
Last reported payment date: 2024-06-18 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($17).
Total Amount
$17
General + Research + Ownership
Payments
1
Total payment records
General Amount
$17
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Merck Sharp & Dohme LLC | $17 |
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: 2022-06-20
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 |
|---|---|---|---|---|
| I20220620001463 | I | Anesthesiology | NC | 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 78234)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | AZ | |
| - | NC | |
| Certified Registered Nurse Anesthetist (Crna) | MS | |
| - | TN | |
| Certified Registered Nurse Anesthetist (Crna) | WV | |
| - | GA | |
| Certified Registered Nurse Anesthetist (Crna) | SC | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| - | NC | |
| A N E S T H E S I O L O G Y | MI |
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