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DR. NIKKI HUGHES MD
NPI 1053490938
Family Medicine in Buford, GA

Active since November 03, 2006PECOS EnrolledAccepts Medicare Assignment
4445 S LEE ST, SUITE 100, BUFORD, GA 30518(770) 848-5200(770) 848-5201 Get Directions Write a Review

NPPES record last updated: September 7, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Nikki Hughes Md NPPES

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

DR. NIKKI HUGHES MD (NPI 1053490938) is an individual family medicine provider in Buford, Georgia, licensed in Georgia (064565) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and is a graduate of University Of South Carolina School Of Medicine (2006).

NPPES Registry Identity

NPI1053490938
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. NIKKI HUGHESCredential: MD
Location Address4445 S LEE ST, SUITE 100Buford, GA 30518-8804
Mailing Address601 S Enota Dr Ne, Suite QGainesville, GA 30501-2400 · (770) 219-8420 · Fax (770) 219-8440
Phone(770) 848-5200
Fax(770) 848-5201
Sole ProprietorYes
Medical School CMSUniversity Of South Carolina School Of MedicineGraduated 2006
Enumeration DateNovember 3, 2006
Last NPPES UpdateSeptember 7, 2012
✔ NPI 1053490938 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in GA · 064565
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.

4445 S LEE ST, Buford, GA 30518
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

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. Nikki Hughes Md 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 ID3779608401
PECOS Enrollment IDI20100917000315
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 8

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.
283 services107 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.
51 services51 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
49 services28 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
38 services18 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.
26 services22 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110005
Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County
Birthing friendly

Northside Hospital Gwinnett

Acute Care Hospitals · Lawrenceville, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110087
Location1000 Medical Center BoulevardLawrenceville, GA 30046 · Gwinnett County
Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110161
Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30518 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
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%215 patients5/55-star benchmark: 100%
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.

Referred Medical Equipment & Supplies CMS DME claims

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 suppliers20 claims71 services$5.61 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 3

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

NORTH ATLANTA PODIATRY GRP,PC
Podiatrist
4445 S LEE ST, STE 200
BUFORD, GA 30518
Gwinnett County (770) 963-5161
MARGARET L. SCHUTTE M.D.
Family Medicine
4445 S LEE ST, STE 100
BUFORD, GA 30518
Gwinnett County (770) 932-3502
DR. ARIF PATNI D.O.
Family Medicine
4445 S LEE ST, SUITE 100
BUFORD, GA 30518
Gwinnett County (770) 848-5200

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 Nikki Hughes's NPI number?

The NPI number for Nikki Hughes is 1053490938. It was assigned to this individual provider in the NPPES registry on November 3, 2006.

Where is Nikki Hughes located?

Nikki Hughes practices at 4445 S Lee St Suite 100, Buford, GA 30518. The listed phone number is (770) 848-5200.

What is Nikki Hughes's specialty?

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

Is Nikki Hughes enrolled in Medicare?

Yes. Nikki Hughes 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.

What insurance does Nikki Hughes accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Nikki Hughes as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Nikki Hughes affiliated with any hospitals?

According to CMS data, Nikki Hughes is affiliated with Northside Hospital Forsyth, Northside Hospital Gwinnett and Northside Hospital.

When was this NPI record last updated?

The NPPES record for Nikki Hughes was last updated on September 7, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.