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

Nicholas Wendell Wickersham, MD

Individual provider Diagnostic Radiology Physician · NPI 1396867222

Nicholas Wendell Wickersham, MD is a Diagnostic Radiology in Boulder, Colorado. Graduated from University of Washington School of Medicine in 2003, 23 years ago. Practices with Boulder Radiologists Inc P C, a 13-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
23
Trained at
University of Washington School of Medicine
Licensed in
CO
In the registry since
2007
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

1100 Balsam Ave
Boulder, CO 80304-3404
Phone: (303) 532-3500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4747 Arapahoe Ave, Boulder, CO 80303-1131 — (877) 465-0012

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 47842 (CO)

Record details

NPI number1396867222
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 3, 2007
Last updated in NPPESMarch 15, 2021
Certification dateMarch 15, 2021

Medicare enrollment

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

Medicare specialtyDIAGNOSTIC RADIOLOGY
Also practisesINTERVENTIONAL RADIOLOGY, NUCLEAR MEDICINE
Medical schoolUNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduated 2003 (23 years in practice)
Group practice Boulder Radiologists Inc P C — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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