MR. NICHOLAS PIERRE LAWYER PA-C
NPI 1043640758
Physician Assistant in Plains, MT

NPI Status: Active since November 15, 2013

Contact Information

110 KRUGER RD
PLAINS, MT
ZIP 59859
Phone: (406) 826-4800

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  • Individual
  • Male
  • Physician Assistant
  • Accepts Insurance
  • PECOS Enrolled

About NICHOLAS LAWYER

This page provides the complete NPI Profile along with additional information for Nicholas Lawyer, a primary care provider established in Plains, Montana with a medical specialization in Physician Assistant. The healthcare provider is registered in the NPI registry with number 1043640758 assigned on November 2013. The practitioner's primary taxonomy code is 363A00000X with license number 28389 (MT). The provider is registered as an individual and his NPI record was last updated 13 years ago.

NPI
1043640758
Provider Name
MR. NICHOLAS PIERRE LAWYER PA-C
Gender
Male
Entity Type
Individual
Location Address
110 KRUGER RD PLAINS, MT 59859
Location Phone
(406) 826-4800
Mailing Address
PO BOX 768 110 KRUGER RD PLAINS, MT 59859
Mailing Phone
(406) 826-4800
Is Sole Proprietor?
No
Enumeration Date
11-15-2013
Last Update Date
11-15-2013
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A primary care provider (PCP) like Nicholas Lawyer sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant

Taxonomy Code
363A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
28389
License State
MT
Taxonomy Description
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Preferred Bronze PPO? 201 - PPO
  • Blue Preferred Bronze PPO? 202 - PPO
  • Blue Preferred Bronze PPO? Standard - PPO
  • Blue Preferred Gold PPO? 204 - PPO
  • Blue Preferred Gold PPO? 901 - PPO
  • Blue Preferred Gold PPO? Standard - PPO
  • Blue Preferred Security PPO? 200 - PPO
  • Blue Preferred Silver PPO? 203 - PPO
  • Blue Preferred Silver PPO? 308 - PPO
  • Blue Preferred Silver PPO? Standard - PPO
  • Peak PPO Bronze HDHP - PPO
  • Peak PPO Bronze Standard - PPO
  • Peak PPO Catastrophic - PPO
  • Peak PPO Gold - PPO
  • Peak PPO Gold Standard - PPO
  • Peak PPO Silver - PPO
  • Peak PPO Silver Standard - PPO
  • Plus Bronze - PPO
  • Plus Bronze Standard - PPO
  • Plus Gold - PPO
  • Plus Gold Standard - PPO
  • Plus Silver Standard - PPO
  • Rocky Mountain Bronze Standard - PPO
  • Rocky Mountain Gold Standard - PPO
  • Rocky Mountain Silver Standard - PPO
  • PEAK PPO BRONZE - PPO
  • PEAK PPO BRONZE HDHP - PPO
  • PEAK PPO GOLD - PPO
  • PEAK PPO GOLD HDHP - PPO
  • PEAK PPO SILVER - PPO
  • Core Bronze HSA 10600 - EPO
  • Core Bronze HSA 7500 - EPO
  • Core Bronze HSA 8300 - EPO
  • Core Gold 1500 - EPO
  • Core Gold 3000 - EPO
  • Core Silver 3500 - EPO
  • Core Silver 4500 - EPO
  • Core Silver 5000 - EPO
  • Core Silver 7500 - EPO
  • Core Standard Expanded Bronze HSA - EPO
  • Core Standard Gold - EPO
  • Core Standard Silver - EPO
  • PacificSource Oregon Standard Bronze HSA Plan Core - EPO
  • PacificSource Oregon Standard Gold Plan Core - EPO
  • PacificSource Oregon Standard Silver Plan Core - EPO
  • HSA Qualified 7500 Bronze - Choice Network - EPO
  • HSA-E Qualified 7500 Bronze - Signature Network - EPO
  • Providence Oregon Standard Bronze Plan - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Choice Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Choice Network - EPO
  • Providence Oregon Standard Silver Plan - Signature Network - EPO

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

Medicare Participation & PECOS Enrollment Status

Nicholas Lawyer 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.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    3 DME suppliers used 16 Medicare Claims 77 Services Paid

  • DME-Other DME (DE001N)

    Full face mask used with positive airway pressure device, each (HCPCS:A7030)

    3 DME suppliers used 44 Medicare Claims 44 Services Paid

  • DME-Other DME (DE001N)

    Face mask interface, replacement for full face mask, each (HCPCS:A7031)

    3 DME suppliers used 102 Medicare Claims 116 Services Paid

  • DME-Other DME (DE001N)

    Cushion for use on nasal mask interface, replacement only, each (HCPCS:A7032)

    4 DME suppliers used 51 Medicare Claims 107 Services Paid

  • DME-Other DME (DE001N)

    Pillow for use on nasal cannula type interface, replacement only, pair (HCPCS:A7033)

    1 DME suppliers used 34 Medicare Claims 67 Services Paid

  • DME-Other DME (DE001N)

    Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)

    4 DME suppliers used 41 Medicare Claims 41 Services Paid

  • DME-Other DME (DE001N)

    Headgear used with positive airway pressure device (HCPCS:A7035)

    5 DME suppliers used 40 Medicare Claims 40 Services Paid

  • DME-Other DME (DE001N)

    Tubing used with positive airway pressure device (HCPCS:A7037)

    3 DME suppliers used 65 Medicare Claims 65 Services Paid

  • DME-Other DME (DE001N)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    5 DME suppliers used 186 Medicare Claims 400 Services Paid

  • DME-Other DME (DE001N)

    Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)

    3 DME suppliers used 27 Medicare Claims 27 Services Paid

  • DME-Oxygen and Supplies (DC000N)

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

    2 DME suppliers used 25 Medicare Claims 25 Services Paid

  • DME-Other DME (DE001N)

    Continuous positive airway pressure (cpap) device (HCPCS:E0601)

    3 DME suppliers used 36 Medicare Claims 37 Services Paid

  • DME-Oxygen and Supplies (DC002N)

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

    3 DME suppliers used 41 Medicare Claims 41 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Portable oxygen concentrator, rental (HCPCS:E1392)

    2 DME suppliers used 16 Medicare Claims 16 Services Paid

  • DME-Other DME (DE017N)

    Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)

    4 DME suppliers used 26 Medicare Claims 26 Services Paid

  • DME-Other DME (DE000N)

    Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)

    2 DME suppliers used 20 Medicare Claims 20 Services Paid

Drugs Administered Through DME

  • DME-Drugs Administered Through DME (DG006N)

    Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)

    1 DME suppliers used 12 Medicare Claims 1386 Services Paid

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 59859 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $87.97
  • Minimum New Patient Price $56.81
  • Maximum New Patient Price $172.26
  • Average New Patient Copayment $21.99
  • Minimum New Patient Copayment $14.2
  • Maximum New Patient Copayment $43.06

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $70.82
  • Minimum Established Patient Price $18.24
  • Maximum Established Patient Price $140.32
  • Average Established Patient Copayment $17.7
  • Minimum Established Patient Copayment $4.56
  • Maximum Established Patient Copayment $35.08

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

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1043640758, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
4
Doubled → 8
Pos 4
3
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
4
Unchanged
Pos 7
0
Doubled → 0
Pos 8
7
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 6 → 12 → 3 0 → 0 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 8 + 3 + 1 + 2 + 4 + 0 + 7 + 1 + 0 + 24 = 52

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 52 is 60. The difference is the calculated check digit.

60 - 52 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1043640758.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Radiology (Neuroradiology)
110 KRUGER RD
PLAINS, MT 59859
Clinic/Center
110 KRUGER RD
PLAINS, MT 59859
Internal Medicine (Cardiovascular Disease)
110 KRUGER RD
PLAINS, MT 59859

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1043640758, enumerated as an "individual" on November 15, 2013.

The provider is located at 110 KRUGER RD PLAINS, MT 59859 and the phone number is (406) 826-4800.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Montana, Mountain. Please consult your insurance carrier or call the provider to verify.