NICOLE S NIPPER NP
NPI 1003016940
Nurse Practitioner in Rochester, MN


Quality Rating: 100 out of 100 score

NPI Status: Active since July 19, 2007

Contact Information

200 1ST ST SW
ROCHESTER, MN
ZIP 55905
Phone: (507) 284-2511

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  • Individual
  • Female
  • Years of Experience 17
  • Nurse Practitioner
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About NICOLE NIPPER

Nicole Nipper is a provider established in Rochester, Minnesota and her medical specialization is Nurse Practitioner with more than 17 years of experience. The healthcare provider is registered in the NPI registry with number 1003016940 assigned on July 2007. The practitioner's primary taxonomy code is 363L00000X with license number 2226 (MN). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI
1003016940
Provider Name
NICOLE S NIPPER NP
Gender
Female
Entity Type
Individual
Location Address
200 1ST ST SW ROCHESTER, MN 55905
Location Phone
(507) 284-2511
Mailing Address
200 1ST ST SW ROCHESTER, MN 55905
Mailing Phone
(507) 284-2511
Medical School Name
OTHER
Graduation Year
2007
Is Sole Proprietor?
No
Enumeration Date
07-19-2007
Last Update Date
10-05-2020
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A nurse practitioner (NP) like Nicole Nipper is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Nicole Nipper is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 100, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The typical physician office visit costs for Medicare beneficiaries in this area are: $22.21 for a new patient copayment and $25.76 for an established patient copayment.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner

Taxonomy Code
363L00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
2226
License State
MN
Taxonomy Description
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1363L00000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner

R 1435810 (MN)

PECOS Enrollment and Medicare Participation Status

Nicole Nipper is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 840386629

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20071010000482

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • Oxygen and supplies (D1C)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    2 DME suppliers used 12 Medicare Claims 12 Services Paid

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 55905 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $88.84
  • Minimum New Patient Price $57.95
  • Maximum New Patient Price $174.84
  • Average New Patient Copayment $22.21
  • Minimum New Patient Copayment $14.48
  • Maximum New Patient Copayment $43.71

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $103.04
  • Minimum Established Patient Price $18.41
  • Maximum Established Patient Price $143.56
  • Average Established Patient Copayment $25.76
  • Minimum Established Patient Copayment $4.6
  • Maximum Established Patient Copayment $35.89

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 100 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 100

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 100

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Nicole Nipper is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
MAYO CLINIC HOSPITAL ROCHESTER1216 SECOND STREET SOUTHWEST
ROCHESTER, MN 55902
(507) 255-1991Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003016940
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003011298
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 1 + 1 + 2 + 9 + 8 + 24 = 50
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1003016940 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1225031875 CHRISTINE MARIA MILLER MD, PHD
Individual
Radiology (Diagnostic Radiology)200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-2511
1316942931DR. EMIL D. KORETZKY MD
Individual
Dermatology200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-2511
1962403873 GLADYS A RADKE PAC
Individual
Physician Assistant200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-2511
1649269408MRS. KILEY JO JOHNSON M.S.
Individual
Genetic Counselor, MS200 1ST ST SW
ROCHESTER, MN 55905
(507) 266-3317
1164407920 LISA K BUSS PHARM.D.
Individual
Pharmacist200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-1094
1295711604 DAVID R DAUGHERTY M.D.
Individual
Psychiatry & Neurology (Psychiatry)200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-2511
1619953130 RENATO D ALARCON M.D.
Individual
Psychiatry & Neurology (Psychiatry)200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-2511
1407832827 TANYA MARIE CADDELL R.PH.
Individual
Pharmacist200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-2511
1841276235 MIGUEL E CABANELA M.D.
Individual
Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery)200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-2511
1336125624 RONALD J FAUST M.D.
Individual
Anesthesiology200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-2511
1558347948 MICHAEL A FARRELL M.D.
Individual
Radiology (Diagnostic Radiology)200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-2511
1356327670 JAMES N INGLE M.D.
Individual
Internal Medicine (Medical Oncology)200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-2511
1881670149 ROSALINA L ABBOUD M.D.
Individual
Obstetrics & Gynecology (Gynecology)200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-2511
1679559058 DAVID R FARLEY M.D.
Individual
Surgery200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-2511
1871579045 PAUL F MCGOUGH M.D.
Individual
Radiology (Diagnostic Radiology)200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-2511
1700862943 DANIEL J BLUM M.D.
Individual
Otolaryngology200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-2511
1407832645 JOHN B COLLINS M.D.
Individual
Family Medicine200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-2511
1164408274 TENG JI M.D.
Individual
Pediatrics200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-2511
1104802347 IAN P CLEMENTS M.D.
Individual
Internal Medicine (Cardiovascular Disease)200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-2511
1780660811 JODI ANN COOK PH. D.
Individual
Audiologist200 1ST ST SW
ROCHESTER, MN 55905
(507) 284-2511

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003016940, enumerated in the NPI registry as an "individual" on July 19, 2007

The provider is located at 200 1st St Sw Rochester, Mn 55905 and the phone number is (507) 284-2511

The provider's speciality is Nurse Practitioner with taxonomy code 363L00000X

The provider has more than 17 years of experience.

Yes, as of May 10, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $88.84 with an average copayment of $22.21 for new patient appointments. Established patients should expect a typical charge of $103.04 and an average copayment of 25.76. Please review your insurance plan or contact the provider directly to determine your specific costs.

The practitioner is affiliated to the following hospital(s): MAYO CLINIC HOSPITAL ROCHESTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on July 19, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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