Mr Karlton E Nicholson I, PMHMP in Goodyear, AZ

Mr Karlton E Nicholson I, PMHMP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Goodyear, Arizona. His current practice location is 1360 N Bullard Ave Ste 200, Goodyear, Arizona. You can reach out to his office (for appointments etc.) via phone at (480) 849-7705.

Mr Karlton E Nicholson I is licensed to practice in Arizona (license number 218165) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1225513138.

Contact Information

	Mr Karlton E Nicholson I, PMHMP
	1360 N Bullard Ave Ste 200, Goodyear, AZ 85395-2711
	(480) 849-7705
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Karlton E Nicholson I
Gender	Male
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	1360 N Bullard Ave Ste 200, Goodyear, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1225513138
Provider Enumeration Date: 09/26/2018
Last Update Date: 01/14/2025

Medicare PECOS Information:

PECOS PAC ID: 7113456195
Enrollment ID: I20250206003043

Medical Identifiers

Medical identifiers for Mr Karlton E Nicholson I such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1225513138	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	218165 (Arizona)	Primary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	RN177663 (Arizona)	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Karlton E Nicholson I allows following entities to bill medicare on his behalf.

Entity Name	Quality Mental Health Services Qmhs Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1770201113 PECOS PAC ID: 6406385483 Enrollment ID: O20250121000293

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Karlton E Nicholson I is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Karlton E Nicholson I, PMHMP 1360 N Bullard Ave Ste 200, Goodyear, AZ 85395-2744 Ph: (480) 849-7705	Mr Karlton E Nicholson I, PMHMP 1360 N Bullard Ave Ste 200, Goodyear, AZ 85395-2711 Ph: (480) 849-7705

Reviews and Comments

Nurse Practitioner Nurses in Goodyear, AZ

Benilde Mwiseneza, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 13555 W Mcdowell Rd, Goodyear, AZ 85395 Phone: 623-295-1190
Mrs. Kathryn Leigh Martinez, ACNPC-AG Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 13555 W Mcdowell Rd Ste 203, Goodyear, AZ 85395 Phone: 623-512-4390
Miss Natisha Lynn Zevnick, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 13555 W Mcdowell Rd Ste 302, Goodyear, AZ 85395 Phone: 623-512-4390
Hussein Haidar, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 13555 W Mcdowell Rd Ste 205, Goodyear, AZ 85395 Phone: 623-295-1190
Amanda Jo Frary, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 13555 W Mcdowell Rd Ste 302, Goodyear, AZ 85395 Phone: 623-404-3046
Shannon Torrez, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 16751 W Shiloh Ave, Goodyear, AZ 85338 Phone: 480-372-7703
Ana Maria Fuentes, ACNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 14415 W Mcdowell Rd Ste D102, Goodyear, AZ 85395 Phone: 623-512-4190 Fax: 623-512-4194

Mr Karlton E Nicholson I, PMHMP - Medicare Nurse Practitioner in Goodyear, AZ