NICHOLAS MOORE SOUTHERTON MSN, CNP
NPI 1013691153
Nurse Practitioner - Gerontology in Stillwater, MN

Q: What is Nicholas Southerton's NPI number?

The NPI number for Nicholas Southerton is 1013691153. It was assigned to this individual provider in the NPPES registry on June 9, 2023.

Q: What is Nicholas Southerton's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Active since June 09, 2023PECOS EnrolledAccepts Medicare Assignment

270 MAIN ST N STE 300, STILLWATER, MN 55082(651) 342-1039(651) 342-1428 Get Directions Write a Review

NPPES record last updated: May 4, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 4, 2026, Jan 10, 2025, Jun 20, 2023 and 1 more (4 updates tracked since 2023).

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About Nicholas Moore Southerton Msn, Cnp NPPES

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

NICHOLAS MOORE SOUTHERTON MSN, CNP (NPI 1013691153) is an individual gerontology provider in Stillwater, Minnesota, licensed in Minnesota (10301) and active in the NPI registry since June 2023. He is enrolled in Medicare PECOS, is affiliated with Abbott Northwestern Hospital, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1013691153

Entity TypeIndividualMale

Primary Taxonomy363LG0600X

Provider Legal NameNICHOLAS MOORE SOUTHERTONCredential: MSN, CNP

Location Address270 MAIN ST N STE 300Stillwater, MN 55082-6788

Mailing Address2124 144th Ln NeHam Lake, MN 55304-6260 · (763) 248-4011

Phone(651) 342-1039

Fax(651) 342-1428

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateJune 9, 2023

Last NPPES UpdateMay 4, 20264 updates tracked since enumeration

NPPES CertifiedMay 4, 2026

✔ NPI 1013691153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in MN · 10301

Also ListedNurse PractitionerTaxonomy 363L00000X · License 10301 (MN)

Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License 10301 (MN)

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License 10301 (MN)

270 MAIN ST N STE 300, Stillwater, MN 55082

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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

Nicholas Moore Southerton Msn, Cnp 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 ID3678934783

PECOS Enrollment IDI20230804000766

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 13

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.

Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes 99350

An established patient home visit is a service where a healthcare professional visits a patient's home for a check-up or treatment. The visit typically lasts for about an hour. This service is especially beneficial for patients who may have difficulty traveling to a healthcare facility.

639 services122 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

66 services51 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.

52 services52 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

51 services33 patients

Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310

A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.

48 services17 patients

Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310

30 services17 patients

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

28 services23 patients

Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348

An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.

24 services23 patients

Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes 99345

A new patient home visit is a comprehensive 75-minute appointment conducted at your home. The healthcare professional will assess your health, discuss any concerns, and create a personalized care plan. It's convenient, comfortable, and tailored to your specific needs.

23 services23 patients

Chronic care management services for two or more chronic conditions, first 30 minutes provided personally by health care professional, per calendar month 99491

Chronic care management services involve a healthcare professional personally providing care for patients with two or more chronic conditions. This service, offered monthly, focuses on the first 30 minutes of care, helping manage and coordinate the patient's health needs.

16 services14 patients

Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a G0179

This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.

16 services12 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

16 services15 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

13 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Abbott Northwestern Hospital

Acute Care Hospitals · Minneapolis, MN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240057

Location800 East 28th StreetMinneapolis, MN 55407 · Hennepin County

Emergency services Birthing friendly

M Health Fairview University Of Mn

Acute Care Hospitals · Minneapolis, MN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240080

Location2450 Riverside AvenueMinneapolis, MN 55454 · Hennepin County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55082 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

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

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.

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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.

LINDSAY M KUPHAL CNP

Nurse Practitioner