Doctor profile · Federal record
Dr. NICHOLAS WICKERSHAM, M.D.
Diagnostic Radiology Physician (CMS: DIAGNOSTIC RADIOLOGY) · BOULDER, CO
- NPI 1396867222
- Accepts Medicare
- 23 yrs in practice
- Male
- Solo practice
- No sanctions
Practice & contact
Operates at 2 locations .
- Primary practice
-
1100 BALSAM AVE
BOULDER, CO 803043404
(303) 532-3500 - Additional location
-
4747 Arapahoe Ave
Boulder, CO 803031131
(877) 465-0012 - Mailing address
-
42 GARDEN CTR
BROOMFIELD, CO 800201730
Credentials & registration
- NPI registered
- April 2007 — 19 yrs on file
- Profile last updated
- March 15, 2021
- Year of graduation
- 2003 — 23 yrs since
- Specialty taxonomy
- 2085R0202X — NUCC code
- State license (1)
- Colorado #47842
- Medicaid
- CO #07101759
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1396867222. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
3,447
Distinct HCPCS
10
Medicare allowed
$131,549
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
71045 |
X-ray of chest, 1 view | 342 | 300 | $9 | |
77063 |
Screening 3d breast mammography | 207 | 207 | $29 | |
77067 |
Screening mammography | 207 | 207 | $37 | |
77085 |
Dxa bone density measurement of hip, pelvis, spine including spine fracture assessment | 173 | 173 | $15 | |
77092 |
Interpretation of trabecular bone score (tbs) and report on fracture risk | 172 | 172 | $10 | |
71046 |
X-ray of chest, 2 views | 169 | 161 | $11 | |
74177 |
Ct scan of abdomen and pelvis with contrast | 163 | 158 | $88 | |
70450 |
Ct scan head or brain without contrast | 156 | 150 | $40 | |
72197 |
Mri scan of pelvis before and after contrast | 107 | 107 | $105 | |
71275 |
Ct scan of blood vessels of chest with contrast | 96 | 95 | $87 |
In context: peer comparison
Among 8 peers in this city , average services per provider: 53. This provider delivers 65× the peer median.Open Payments
Industry payments received
All-time total
$20
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| HEARTFLOW, INC. | 1 | $20.30 |