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

Dr. Michael Tysen Nickle, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1417525601

Dr. Michael Tysen Nickle, DO is a Family Practice in Pueblo, Colorado. Graduated from Rocky Vista University College of Osteopathic Med in 2021, 5 years ago. Practices with Valley-Wide Health Systems, Inc, a 38-clinician group and accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
5
Trained at
Rocky Vista University College of Osteopathic Med
Licensed in
CO
In the registry since
2021
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

902 Lakeview Ave
Pueblo, CO 81004-3597
Phone: (719) 557-5872
Fax: (719) 557-4780
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence TL.0009001 (CO)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence TL.0009001 (CO)

Record details

NPI number1417525601
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 14, 2021
Last updated in NPPESJune 29, 2021
Certification dateJune 29, 2021

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolROCKY VISTA UNIVERSITY COLLEGE OF OSTEOPATHIC MED
Graduated 2021 (5 years in practice)
Group practice Valley-Wide Health Systems, Inc. — 38 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Pueblo