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

Dr. Leroy Nickles, MD

Individual provider Emergency Medicine Physician · NPI 1710070412

Dr. Leroy Nickles, MD is an Emergency Medicine in New York, New York. Graduated from Pennsylvania State University College of Medicine in 2002, 24 years ago. Practices with Emergency Physician Services of New Jersey, Professional Association, a 51-clinician group and accepts Medicare assignment. Licensed in Michigan, New York and Pennsylvania.

Years since qualifying
24
Trained at
Pennsylvania State University College of Medicine
Licensed in
MI, NY, PA
In the registry since
2006
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

170 W 12th St Emergency Dept Administration
New York, NY 10011-8202
Phone: (212) 604-2590
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 236503 (NY)
Emergency Medicine Physician Taxonomy 207P00000X · Licence MD425081 (PA)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 4301511279 (MI)

Record details

NPI number1710070412
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 2, 2006
Last updated in NPPESMarch 21, 2024
Certification dateMarch 21, 2024

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolPENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated 2002 (24 years in practice)
Group practice Emergency Physician Services Of New Jersey,Professional Association — 51 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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