DR. NICKOLAS JR. HADLEY (DO) – Family Medicine Physician, NPI 1164962221

DR. NICKOLAS JR. HADLEY (DO) is a healthcare provider. based in Tacoma, Washington. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. U8993 (TX). The NPI Number for DR. NICKOLAS JR. HADLEY (DO) is 1164962221

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
DR. NICKOLAS JR. HADLEY (DO)
NPI
1164962221
Phone
(253) 968-0770
Address
9040 JACKSON AVE
Enumeration Date
8 March 2017
Last Update Date
28 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5127785160
Graduation Year
2017 (9 years ago)
PAC ID
4981954500
Group Practice PAC ID
7719875491
Professional Enrollment ID
I20240515002585
Address ID
TX786424438LI1436510XX600
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:9State licenses:1Digital endpointsOther names

4,141 FAMILY PRACTICE in WA

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Provider Addresses for DR. NICKOLAS JR. HADLEY (DO)

  • Madigan Army Medical Center, 9040, Jackson Avenue, Tacoma, Pierce County, Washington, 98431, United States

    TACOMA, WA 984311100

    Phone: (253) 968-0770

    Fax: (253) 968-2608

    Type: Mailing

  • 14365 HWY 29 W

    SUITE 10

    LIBERTY HILL, TX 78642

    Phone: (512) 778-5160

    Fax: (512) 778-6847

    Type: Mailing

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: 2024-05-15

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
I20240515002585IFamily PracticeTXTBD

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 98431)

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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: 7719875491View full group profile
NameSpecialtyState
Internal MedicineTX
Family PracticeTX
-TX
Internal Medicine, Critical Care (Intensivists)TX
Nurse PractitionerTX
Nurse PractitionerTX
Internal MedicineTX
-VA
Family PracticeTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

What number should I use to identify DR. NICKOLAS JR. HADLEY (DO) for billing?
Administrative and clinical systems typically use NPI 1164962221 for DR. NICKOLAS JR. HADLEY (DO).
Quick check: is DR. NICKOLAS JR. HADLEY (DO) active?
Public NPPES data shows DR. NICKOLAS JR. HADLEY (DO) with an active NPI status right now.
What does the directory say DR. NICKOLAS JR. HADLEY (DO) does?
Insurance directories may phrase it differently, but here DR. NICKOLAS JR. HADLEY (DO) maps to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Can patients visit DR. NICKOLAS JR. HADLEY (DO) in Tacoma, Washington?
For routing, start with Tacoma, Washington for DR. NICKOLAS JR. HADLEY (DO), then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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