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

John Eliot Nicolaisen, PA

Individual provider Medical Physician Assistant · NPI 1548666738

John Eliot Nicolaisen, PA is a Physician Assistant in Apple Valley, California. Qualified in 2014, 12 years ago. Practices with Bear Valley Community Health Care District, a 28-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
12
Licensed in
CA
In the registry since
2014
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

18523 Corwin Rd Ste G
Apple Valley, CA 92307-2300
Phone: (760) 242-3376
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA52168 (CA)

Record details

NPI number1548666738
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 14, 2014
Last updated in NPPESSeptember 11, 2017

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Bear Valley Community Health Care District — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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