MEDICARE: NICOLAUS D WINTERS MD

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	46334	KY
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	036149268	IL
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	01074139	IN

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P02271332	OTHER	IL	RAILROAD MEDICARE
4	P01590222	OTHER	KY	RAILROAD MEDICARE
6	P01607483	OTHER	IN	RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	QZZ000000165167	OTHER	KY	AETNA BETTER HEALTH OF KY PROVIDER ID NUMBER
3	1564011	OTHER		CIGNA PROVIDER ID NUMBER
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	000000955100	OTHER		ANTHEM PIN
8	1232425	OTHER	KY	WELLCARE OF KY PROVIDER ID NUMBER
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	CS1604700123	OTHER		CARESOURCE ID
11	005120936	OTHER		UNITED HEALTHCARE PROVIDER ID
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	7638957	OTHER		AETNA PIN

NPI Number	:	1750522660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLAUS D WINTERS MD

Provider Business Mailing Address
First Line	:	PO BOX 21890
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4115
Country	:	US
Telephone Number	:	502-409-9925
Fax Number	:	502-919-9780

Provider Business Practice Location Address
First Line	:	700 KIMBER LANE
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-2803
Country	:	US
Telephone Number	:	812-476-7111
Fax Number	:	812-476-7117

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2009
Last Update Date	:	02/13/2024