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

Timothy Robert Nickolaus, PA

Individual provider Medical Physician Assistant · NPI 1518250554

Timothy Robert Nickolaus, PA is a Physician Assistant in Richland, Washington. Qualified in 2010, 16 years ago. Practices with Kadlec Regional Medical Center, a 396-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
16
Licensed in
WA
In the registry since
2011
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

875 Swift Blvd
Richland, WA 99352-3592
Phone: (509) 946-1654
Fax: (509) 943-5652
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1351 Fowler St, Richland, WA 99352-4714 — (509) 946-1654

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA60217353 (WA)

Record details

NPI number1518250554
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 24, 2011
Last updated in NPPESJune 22, 2021
Certification dateJune 22, 2021
Mailing address560 Gage Blvd, Suite 203, Richland, WA 99352

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Kadlec Regional Medical Center — 396 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Richland