NICOLE BAUMGARTNER-FERNANDEZ DO
NPI 1003266396
Internal Medicine in Reading, PA

Q: What is Nicole Baumgartner-fernandez's NPI number?

The NPI number for Nicole Baumgartner-fernandez is 1003266396. It was assigned to this individual provider in the NPPES registry on June 16, 2016. The provider is also known as Nicole Baumgartner.

Q: What is Nicole Baumgartner-fernandez's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since June 16, 2016PECOS EnrolledAccepts Medicare Assignment

71.53/100

CMS Quality Rating

2500 BERNVILLE RD, READING, PA 19605(610) 378-2000(610) 378-2799 Get Directions Write a Review

NPPES record last updated: August 2, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 28, 2023, Jun 16, 2016 (2 updates tracked since 2016).

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About Nicole Baumgartner-fernandez Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE BAUMGARTNER-FERNANDEZ DO (NPI 1003266396) is an individual internal medicine provider in Reading, Pennsylvania, licensed in Pennsylvania (OS022984) and active in the NPI registry since June 2016. She is enrolled in Medicare PECOS, is affiliated with Penn State Health St. Joseph, and maintains a secondary practice location in Largo.

NPPES Registry Identity

NPI1003266396

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameNICOLE BAUMGARTNER-FERNANDEZCredential: DO

Location Address2500 BERNVILLE RDReading, PA 19605-9453

Mailing Address500 University DrHershey, PA 17033-2360 · (610) 208-4648

Phone(610) 378-2000

Fax(610) 378-2799

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateJune 16, 2016

Last NPPES UpdateAugust 2, 20232 updates tracked since enumeration

NPPES CertifiedAugust 2, 2023

✔ NPI 1003266396 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in PA · OS022984✔ Licensed in FL · U04866✔ Licensed in WA · OP61241760

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

2500 BERNVILLE RD, Reading, PA 19605

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Other Names 1

Former Name (1)Nicole Baumgartner

Secondary Practice Location 1

Location 1201 14th St SWLargo, FL 33770-3133 · Phone (727) 588-5704

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicole Baumgartner-fernandez Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4880921287

PECOS Enrollment IDI20230816003789

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Nicole Baumgartner-fernandez reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

St. Joseph Medical Group

Same address

Anesthesiology

2500 BERNVILLE RD
Reading, PA 19605

Reassigned Medicare billing, Pennsylvania enrollment
251 clinicians in this Medicare group

NPI 1841680881 (610) 378-2055

Penn State Health Medical Group, LLC

0.2 mi

Orthopaedic Surgery

2494 BERNVILLE RD STE 200
Reading, PA 19605

Reassigned Medicare billing, Pennsylvania enrollment
994 clinicians in this Medicare group

NPI 1942955521 (610) 378-2996

Hospitalist Medicine Physicians Of Pennsylvania, P.C.

166 mi

Internal Medicine

225 S CENTER AVE
Somerset, PA 15501

Reassigned Medicare billing, Pennsylvania enrollment
Medicare enrollment name: Hospitalist Medicine Physicians Of Pennsylvania PC
274 clinicians in this Medicare group

NPI 1639464308 (814) 443-5000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

346 services185 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

137 services133 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

113 services80 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Penn State Health St. Joseph

Acute Care Hospitals · Reading, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390096

Location2500 Bernville RoadReading, PA 19605 · Berks County

Emergency services Birthing friendly

Milton S Hershey Medical Center

Acute Care Hospitals · Hershey, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390256

Location500 University DriveHershey, PA 17033 · Dauphin County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19605 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

71.53/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

55.53

Promoting Interoperability

100

Improvement Activities

Cost

49.57

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier19 claims19 services$16.30 avg. paid by Medicare

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

DME-Oxygen and Supplies · category DC002N

2 suppliers24 claims24 services$82.67 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. STEVEN RICHARD CHMIELEWSKI MD

Radiology (Diagnostic Radiology)