TIMOTHY NICHOLSON NPI 1013091941
Internal Medicine in Burnt Hills, NY

About TIMOTHY NICHOLSON

Timothy Nicholson is an internist established in Burnt Hills, New York and his medical specialization is Internal Medicine with more than 25 years of experience. He graduated from Boston University School Of Medicine in 1998. The NPI number of Timothy Nicholson is 1013091941 and was assigned on October 2006. The practitioner's primary taxonomy code is 207R00000X with license number 217445 (NY). The provider is registered as an individual and his NPI record was last updated 10 years ago.

NPI
1013091941
Provider Name TIMOTHY NICHOLSON
Location Address1184 STATE ROUTE 50 BURNT HILLS, NY 12019
Location Phone(518) 384-1281
Mailing Address711 TROY SCHENECTADY RD SUITE 201 LATHAM, NY 12110
GenderMale
NPI Entity TypeIndividual
Medical School NameBOSTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year1998
Is Sole Proprietor?No
Enumeration Date10-25-2006
Last Update Date02-08-2013

An internist like Timothy Nicholson is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.Timothy Nicholson 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.

Timothy Nicholson is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Ellis Hospital.

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.94 for a new patient copayment and $25.46 for an established patient copayment.



Primary Taxonomy

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Taxonomy Code207R00000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
License No.217445
License StateNY
Taxonomy DescriptionA 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.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:

  • Medicaid
  • Medicare

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Business Address

TIMOTHY NICHOLSON
1184 STATE ROUTE 50
BURNT HILLS, NY
ZIP 12019
Phone: (518) 384-1281

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Mailing Address

TIMOTHY NICHOLSON
711 TROY SCHENECTADY RD
SUITE 201
LATHAM, NY
ZIP 12110
Phone:


Location Map

PECOS Enrollment and Medicare Participation Status

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID9436286465
PECOS Enrollment IDI20100423000237
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 order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 12019 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$57.17 $174.05 $131.79
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.29 $43.51 $32.94
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$17.76 $142.28 $101.85
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.44 $35.57 $25.46

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

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 138Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • 90Complete blood cell count (red cells, white blood cell, platelets), automated test (HCPCS:85025)
  • 43Hemoglobin A1C level (HCPCS:83036)
  • 25Administration of influenza virus vaccine (HCPCS:G0008)
  • 17Administration of pneumococcal vaccine (HCPCS:G0009)
  • 15Routine EKG using at least 12 leads including interpretation and report (HCPCS:93000)
  • 13Pneumococcal vaccine for injection into muscle (HCPCS:90670)
  • 11Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare 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. Timothy Nicholson is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
ELLIS HOSPITAL1101 NOTT STREET
SCHENECTADY, NY 12308
(518) 243-4000Acute Care Hospitals330153

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1208000000XAllopathic & Osteopathic PhysiciansPediatrics217445NYNo

Taxonomy Description: a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
H68449MEDICARE UPIN (02)NY
DD2078MEDICARE PIN (08)NY
02349659MEDICAID (05)NY

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.
1013091941
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
202309298
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 2 + 3 + 0 + 9 + 2 + 9 + 8 + 24 = 59
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 59 = 11

The NPI number 1013091941 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 6 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1134403561COMMUNITY CARE PHYSICIANS, PC
Organization
Internal Medicine1184 STATE ROUTE 50
BALLSTON LAKE, NY 12019
(518) 384-1281
1831273762 JAMES GAYLORD
Individual
Internal Medicine1184 STATE ROUTE 50
BALLSTON LAKE, NY 12019
(518) 384-1281
1952753550 REBECCA LAMANNA PNP
Individual
Nurse Practitioner (Pediatrics)1184 STATE ROUTE 50
BALLSTON LAKE, NY 12019
(518) 384-1281
1366942385 KIMBERLY ANN RIGGI FNP
Individual
Nurse Practitioner (Family)1184 STATE ROUTE 50
BALLSTON LAKE, NY 12019
(518) 384-1281
1013356500 PAULA M HAYES FNP
Individual
Nurse Practitioner (Family)1184 STATE ROUTE 50
BALLSTON LAKE, NY 12019
(518) 384-1281
1861802050 ALEXA SUZANNE PALMIERI PA-C
Individual
Physician Assistant1184 STATE ROUTE 50
BALLSTON LAKE, NY 12019
(518) 384-1281

Frequently Asked Questions

What is Timothy Nicholson NPI number?

The NPI number assigned to Timothy Nicholson is 1013091941, registered as an "individual" on October 25, 2006

Where is Timothy Nicholson located?

The provider is located at 1184 State Route 50 Burnt Hills, Ny 12019 and the phone number is (518) 384-1281

Which is Timothy Nicholson specialty?

The provider's speciality is Internal Medicine

How many years of experience does Timothy Nicholson have?

The provider has more than 25 years of experience. He graduated from Boston University School Of Medicine in 1998.

What insurance does Timothy Nicholson accept?

The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.

Is Timothy Nicholson registered in PECOS?

Yes, as of November 14, 2022 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare 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.

How much is a visit to Timothy Nicholson ?

Medicare beneficiaries should expect a typical cost of $131.79 with an average copayment of $32.94 for new patient appointments. Established patients should expect a typical charge of $101.85 and an average copayment of 25.46. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Timothy Nicholson ?

The most common procedures or services performed by this practitioner are: Insertion of needle into vein for collection of blood sample, Complete blood cell count (red cells, white blood cell, platelets), automated test, Hemoglobin A1C level, Administration of influenza virus vaccine, Administration of pneumococcal vaccine, Routine EKG using at least 12 leads including interpretation and report, Pneumococcal vaccine for injection into muscle and Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit.

Is Timothy Nicholson affiliated to any hospitals?

The practitioner is affiliated to the following hospitals: ELLIS HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

How do I update my NPI information?

The NPI record of Timothy Nicholson was last updated on October 25, 2006. 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]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]