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DR. NICHOLAS H. PSIMOS D.D.S, PLC
NPI 1083681928
Dentist - Oral and Maxillofacial Surgery in Rochester, MN

Active since February 28, 2006Opted out of Medicare · through Feb 23, 2028
1101 N BROADWAY, ROCHESTER, MN 55906(507) 288-0126(507) 529-0810 Get Directions Write a Review

NPPES record last updated: April 21, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Nicholas H. Psimos D.d.s, Plc NPPES

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

DR. NICHOLAS H. PSIMOS D.D.S, PLC (NPI 1083681928) is an individual oral and maxillofacial surgery provider in Rochester, Minnesota, licensed in Minnesota (D10595) and active in the NPI registry since February 2006. He has opted out of Medicare through February 23, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1083681928
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. NICHOLAS H. PSIMOSCredential: D.D.S, PLC
Location Address1101 N BROADWAYRochester, MN 55906-6841
Mailing Address1101 N BroadwayRochester, MN 55906-6841 · (507) 288-0126 · Fax (507) 529-0810
Phone(507) 288-0126
Fax(507) 529-0810
Sole ProprietorYes
Enumeration DateFebruary 28, 2006
Last NPPES UpdateApril 21, 2011
✔ NPI 1083681928 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in MN · D10595
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
1101 N BROADWAY, Rochester, MN 55906
Open in Google Maps ↗

Other Identifiers 5

Other1B261PSMN · Bcbs Provider Id
Medicaid0088575IA
Medicare ID-Type Unspecified190000453MN
Medicaid324222600MN
Medicare UPINT91003MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Nicholas H. Psimos D.d.s, Plc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 23, 2016 through February 23, 2028.

Opt-Out Effective DateFebruary 23, 2016
Opt-Out In Effect ThroughFebruary 23, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55906 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
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.

Other Providers at the Same Location NPPES

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

NICHOLAS H. PSIMOS, DDS, PLC
Dentist (Oral and Maxillofacial Surgery)
1101 N BROADWAY
ROCHESTER, MN 55906
Olmsted County (507) 288-0126

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 Nicholas Psimos's NPI number?

The NPI number for Nicholas Psimos is 1083681928. It was assigned to this individual provider in the NPPES registry on February 28, 2006.

Where is Nicholas Psimos located?

Nicholas Psimos practices at 1101 N Broadway, Rochester, MN 55906. The listed phone number is (507) 288-0126.

What is Nicholas Psimos's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Nicholas Psimos enrolled in Medicare?

No. Nicholas Psimos has opted out of Medicare through February 23, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Nicholas Psimos accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Delta Dental of Iowa and 3 other insurers list Nicholas Psimos 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.

When was this NPI record last updated?

The NPPES record for Nicholas Psimos was last updated on April 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.