Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

David William Nickels

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1083345607

David William Nickels is a Physician Assistant in Syracuse, New York. Qualified in 2023, 3 years ago. Practices with St Josephs Medical PC, a 385-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
3
Licensed in
NY
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

1419 Salt Springs Rd
Syracuse, NY 13214-1301
Phone: (315) 445-4100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 030786 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1083345607
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 23, 2022
Last updated in NPPESJanuary 9, 2024
Certification dateJanuary 9, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice St Josephs Medical Pc — 385 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Syracuse