DR. KELLYROSE MARY NICHOLS D.O.
NPI 1013274638
Family Medicine in Le Roy, NY

Q: What is Kellyrose Nichols's NPI number?

The NPI number for Kellyrose Nichols is 1013274638. It was assigned to this individual provider in the NPPES registry on April 20, 2012.

Q: What is Kellyrose Nichols's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Kellyrose Nichols was last updated on June 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 20, 2012PECOS EnrolledAccepts Medicare Assignment

76.84/100

CMS Quality Rating

8745 LAKE STREET RD, LE ROY, NY 14482(585) 768-2620 Get Directions Write a Review

NPPES record last updated: June 28, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Kellyrose Mary Nichols D.o. NPPES

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

DR. KELLYROSE MARY NICHOLS D.O. (NPI 1013274638) is an individual family medicine provider in Le Roy, New York, licensed in New York (279405) and active in the NPI registry since April 2012. She is enrolled in Medicare PECOS, is affiliated with Strong Memorial Hospital, and is a graduate of Philadelphia College Of Osteopathic Medicine (2012).

NPPES Registry Identity

NPI1013274638

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. KELLYROSE MARY NICHOLSCredential: D.O.

Location Address8745 LAKE STREET RDLe Roy, NY 14482-9344

Mailing Address8745 Lake Street RdLe Roy, NY 14482-9344 · (585) 768-2620

Phone(585) 768-2620

Sole ProprietorNo

Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 2012

Enumeration DateApril 20, 2012

Last NPPES UpdateJune 28, 2023

✔ NPI 1013274638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NY · 279405

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

8745 LAKE STREET RD, Le Roy, NY 14482

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kellyrose Mary Nichols D.o. 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 ID1355658519

PECOS Enrollment IDI20150921001340

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.

Areas of Expertise CMS Part B claims 4

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

70 services49 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

67 services67 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

41 services30 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Strong Memorial Hospital

Acute Care Hospitals · Rochester, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330285

Location601 Elmwood AveRochester, NY 14642 · Monroe County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14482 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

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

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.

76.84/100

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

Scored as part of a group practice

Quality

68.2

Promoting Interoperability

100

Improvement Activities

Cost

42.68

Referred Medical Equipment & Supplies CMS DME claims 5

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

5 suppliers26 claims55 services$4.60 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

5 suppliers18 claims19 services$0.79 avg. paid by Medicare

Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty E0181

DME-Other DME · category DE000N

1 supplier13 claims13 services$16.60 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier34 claims34 services$7.17 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 suppliers11 claims11 services$119.49 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 6

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

DR. GEORGE ROBERT VITO D.P.M.

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