ANDREA M NICHOLS MD
NPI 1053496422
Family Medicine in Bronx, NY

NPI Status: Active since October 26, 2006

Contact Information

979 CROSS BRONX EXPY
BRONX, NY
ZIP 10460
Phone: (718) 665-7565
Fax: (718) 665-7565

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  • Individual
  • Female
  • Family Medicine
  • PECOS Enrolled

About ANDREA NICHOLS

This page provides the complete NPI Profile along with additional information for Andrea Nichols, a primary care provider established in Bronx, New York with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1053496422 assigned on October 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 207843 (NY). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI
1053496422
Provider Name
ANDREA M NICHOLS MD
Gender
Female
Entity Type
Individual
Location Address
979 CROSS BRONX EXPY BRONX, NY 10460
Location Phone
(718) 665-7565
Location Fax
(718) 665-7565
Mailing Address
979 CROSS BRONX EXPY BRONX, NY 10460
Mailing Phone
(718) 665-7565
Is Sole Proprietor?
No
Enumeration Date
10-26-2006
Last Update Date
04-10-2024
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A primary care provider (PCP) like Andrea Nichols 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

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
207843
License State
NY
Taxonomy Description
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.

Insurance Plans Accepted

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

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

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

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
00695941MEDICAID (05)NY 

Medicare Participation & PECOS Enrollment Status

Andrea Nichols 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.

Orthotic Devices

  • DME-Orthotic Devices (DF008N)

    Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each (HCPCS:A4351)

    1 DME suppliers used 12 Medicare Claims 1800 Services Paid

Unknown

  • Other-Enteral and Parenteral (OB006N)

    Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape (HCPCS:B4035)

    1 DME suppliers used 13 Medicare Claims 390 Services Paid

Drugs Administered Through DME

  • DME-Drugs Administered Through DME (DG006N)

    Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)

    6 DME suppliers used 24 Medicare Claims 7743 Services Paid

  • DME-Drugs Administered Through DME (DG000N)

    Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg (HCPCS:J7626)

    2 DME suppliers used 12 Medicare Claims 720 Services Paid

Durable Medical Equipment

  • DME-Other DME (DE000N)

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

    6 DME suppliers used 26 Medicare Claims 26 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 10460 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $105.06
  • Minimum New Patient Price $67.4
  • Maximum New Patient Price $203.53
  • Average New Patient Copayment $26.26
  • Minimum New Patient Copayment $16.85
  • Maximum New Patient Copayment $50.88

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $117.62
  • Minimum Established Patient Price $21.66
  • Maximum Established Patient Price $164.45
  • Average Established Patient Copayment $29.4
  • Minimum Established Patient Copayment $5.41
  • Maximum Established Patient Copayment $41.11

* 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 1053496422, we treat the final digit (2) 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 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

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

Step 2: Add all digits plus the NPI constant

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

2 + 0 + 1 + 0 + 3 + 8 + 9 + 1 + 2 + 4 + 4 + 24 = 58

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

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1053496422.

Other Providers at the Same Location


The following 10 providers are registered at the same or a nearby location.

Occupational Therapist (Physical Rehabilitation)
979 CROSS BRONX EXPY, SERVICE ROAD NORTH
BRONX, NY 10460
Physical Therapist
979 CROSS BRONX EXPY
BRONX, NY 10460
Nurse Practitioner (Family)
979 CROSS BRONX EXPY
BRONX, NY 10460
Physical Therapy Assistant
979 CROSS BRONX EXPY
BRONX, NY 10460
Clinic/Center (Federally Qualified Health Center (FQHC))
979 CROSS BRONX EXPY, SERVICE ROAD NORTH
BRONX, NY 10460
Speech-Language Pathologist
979 CROSS BRONX EXPY, SR NORTH
BRONX, NY 10460
Nurse Practitioner (Psychiatric/Mental Health)
979 CROSS BRONX EXPY
BRONX, NY 10460
Nurse Practitioner (Psychiatric/Mental Health)
979 CROSS BRONX EXPY
BRONX, NY 10460
Internal Medicine
979 CROSS BRONX EXPY
BRONX, NY 10460
Dental Hygienist
979 CROSS BRONX EXPY
BRONX, NY 10460

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053496422, enumerated as an "individual" on October 26, 2006.

The provider is located at 979 CROSS BRONX EXPY BRONX, NY 10460 and the phone number is (718) 665-7565.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.