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DR. RACHELLE NELSON M.D.
NPI 1023438389
Family Medicine in Philadelphia, PA

Active since April 24, 2014PECOS EnrolledAccepts Medicare Assignment
111 S 11TH ST, PHILADELPHIA, PA 19107(215) 955-6060 Get Directions Write a Review

NPPES record last updated: April 5, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 5, 2024, Feb 17, 2020, Feb 15, 2016 (3 updates tracked since 2016).

About Dr. Rachelle Nelson M.d. NPPES

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

DR. RACHELLE NELSON M.D. (NPI 1023438389) is an individual family medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD463547) and active in the NPI registry since April 2014. She is enrolled in Medicare PECOS, is affiliated with Cooper University Hospital, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1023438389
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. RACHELLE NELSONCredential: M.D.
Location Address111 S 11TH STPhiladelphia, PA 19107-4824
Mailing Address833 Chestnut Street, Suite 701Philadelphia, PA 19107 · (215) 955-0735 · Fax (215) 503-9239
Phone(215) 955-6060
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateApril 24, 2014
Last NPPES UpdateApril 5, 20243 updates tracked since enumeration
NPPES CertifiedApril 5, 2024
✔ NPI 1023438389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in PA · MD463547✔ Licensed in PA · MT205956
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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License MT205956 (PA)
111 S 11TH ST, Philadelphia, PA 19107
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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. Rachelle Nelson M.d. 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 ID143525915
PECOS Enrollment IDI20250225003516
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 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 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.
109 services53 patients
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.
92 services39 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.
13 services13 patients

Hospital Affiliations CMS Care Compare 3

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

Cooper University Hospital

Acute Care Hospitals · Camden, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310014
Location1 Cooper PlazaCamden, NJ 08103 · Camden County
Emergency services Birthing friendly

Jefferson Stratford Hospital

Acute Care Hospitals · Stratford, NJ
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310086
Location18 East Laurel RoadStratford, NJ 08084 · Camden County
Emergency services Birthing friendly

Thomas Jefferson University Hospital

Acute Care Hospitals · Philadelphia, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390174
Location111 South 11th StreetPhiladelphia, PA 19107 · Philadelphia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19107 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
$92.69 typical visit price
range $59.88 – $180.99
Typical copayment $23.17 (range $14.97 – $45.24)
Most-billed visit code 99203
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
52%174 patients3/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
42%268 patients2/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
18%89 patients1/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
93%1,905 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
86%337 patients4/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
86%143 patients2/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
28%1,086 patients2/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
92%1,086 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
20%1,086 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
23%1,086 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

NICOLE LYNN RENALDI D.O.
Anesthesiology
111 S 11TH ST, SUITE 8490
PHILADELPHIA, PA 19107
Philadelphia County (215) 955-6161
LING FAN
Nurse Practitioner (Acute Care)
111 S 11TH ST, GIBBON BLDG., SUITE 6270
PHILADELPHIA, PA 19107
Philadelphia County (215) 955-8304
WILLIAM JUSTICE MD
Student in an Organized Health Care Education/Training Program
111 S 11TH ST
PHILADELPHIA, PA 19107
Philadelphia County (215) 995-6000
DR. DAVID P. FRIEDMAN M.D.
Radiology (Diagnostic Radiology)
111 S 11TH ST, SUITE 3390
PHILADELPHIA, PA 19107
Philadelphia County (215) 955-2900
DR. WALTER K. KRAFT M.D.
Internal Medicine
111 S 11TH ST, SUITE 6270
PHILADELPHIA, PA 19107
Philadelphia County (215) 955-6540
DR. TAKI GALANIS M.D.
Internal Medicine
111 S 11TH ST, SUITE 6270
PHILADELPHIA, PA 19107
Philadelphia County (215) 955-6540
DR. STEVEN M LUDWIN M.D.
Internal Medicine
111 S 11TH ST, SUITE 2170
PHILADELPHIA, PA 19107
Philadelphia County (215) 955-6610
JENNIFER L SWOPE CRNA
Nurse Anesthetist, Certified Registered
111 S 11TH ST, SUITE 8490
PHILADELPHIA, PA 19107
Philadelphia County (215) 955-6161

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rachelle Nelson's NPI number?

The NPI number for Rachelle Nelson is 1023438389. It was assigned to this individual provider in the NPPES registry on April 24, 2014.

Where is Rachelle Nelson located?

Rachelle Nelson practices at 111 S 11th St, Philadelphia, PA 19107. The listed phone number is (215) 955-6060.

What is Rachelle Nelson's specialty?

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

Is Rachelle Nelson enrolled in Medicare?

Yes. Rachelle Nelson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Rachelle Nelson affiliated with any hospitals?

According to CMS data, Rachelle Nelson is affiliated with Cooper University Hospital, Jefferson Stratford Hospital and Thomas Jefferson University Hospital.

When was this NPI record last updated?

The NPPES record for Rachelle Nelson was last updated on April 5, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.