NICOLE MARIE PUMARIEGA M.D.
NPI 1053793182
Ophthalmology in Morgantown, WV

Q: What is Nicole Pumariega's NPI number?

The NPI number for Nicole Pumariega is 1053793182. It was assigned to this individual provider in the NPPES registry on June 25, 2015.

Q: What is Nicole Pumariega's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Pumariega was last updated on April 12, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 25, 2015PECOS EnrolledAccepts Medicare Assignment

94.1/100

CMS Quality Rating

1 MEDICAL CENTER DR, MORGANTOWN, WV 26506(856) 342-2000 Get Directions Write a Review

NPPES record last updated: April 12, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 12, 2022, Dec 10, 2019 (2 updates tracked since 2019).

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About Nicole Marie Pumariega M.d. NPPES

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

NICOLE MARIE PUMARIEGA M.D. (NPI 1053793182) is an individual ophthalmology provider in Morgantown, West Virginia, licensed in West Virginia (29175) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS, is affiliated with West Virginia University Hospitals, Inc, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1053793182

Entity TypeIndividualFemale

Primary Taxonomy207W00000X

Provider Legal NameNICOLE MARIE PUMARIEGACredential: M.D.

Location Address1 MEDICAL CENTER DRMorgantown, WV 26506-1200

Mailing Address1 Cooper PlzCamden, NJ 08103-1461 · (856) 342-2000

Phone(856) 342-2000

Sole ProprietorYes

Medical School CMSOtherGraduated 2015

Enumeration DateJune 25, 2015

Last NPPES UpdateApril 12, 20222 updates tracked since enumeration

NPPES CertifiedApril 12, 2022

✔ NPI 1053793182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in WV · 29175

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

1 MEDICAL CENTER DR, Morgantown, WV 26506

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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

Nicole Marie Pumariega 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 ID7012249816

PECOS Enrollment IDI20191028003280

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 12

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.

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

499 services297 patients

Injection of drug into eye 67028

An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.

226 services83 patients

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.

223 services171 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.

175 services148 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

79 services69 patients

Imaging of retina 92134

77 services44 patients

Injection of drug into eye 67028

66 services21 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

52 services52 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

42 services28 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

20 services20 patients

Photocoagulation treatment to prevent detachment of retina 67145

Photocoagulation is a procedure used to treat retinal disorders. A special laser is directed at the retina to create small burns. These burns form scar tissue which helps to secure the retina to the eye's wall, preventing detachment and preserving vision.

13 services12 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

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.

West Virginia University Hospitals, Inc

Acute Care Hospitals · Morgantown, WV

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number510001

Location1 Medical Center DriveMorgantown, WV 26506 · Monongalia County

Emergency services Birthing friendly

United Hospital Center, Inc

Acute Care Hospitals · Bridgeport, WV

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number510006

Location327 Medical Park DriveBridgeport, WV 26330 · Harrison County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 26506 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

$124.46 typical visit price

range $53.20 – $164.59

Typical copayment $31.11 (range $13.30 – $41.14)

Most-billed visit code 99204

Established Patient

$66.84 typical visit price

range $16.47 – $133.29

Typical copayment $16.71 (range $4.11 – $33.32)

Most-billed visit code 99213

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.

94.1/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

78.46

Promoting Interoperability

100

Improvement Activities

Leave this field empty

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.

MIKE LEE MD, MS, BS

Radiology (Neuroradiology)