NICOLE J CHARLES PAC
NPI 1104008093
Physician Assistant - Medical in Waconia, MN

Q: What is Nicole Charles's NPI number?

The NPI number for Nicole Charles is 1104008093. It was assigned to this individual provider in the NPPES registry on December 3, 2007.

Q: What is Nicole Charles's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Charles was last updated on March 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since December 03, 2007PECOS EnrolledAccepts Medicare Assignment

500 S MAPLE ST, WACONIA, MN 55387(952) 442-2191(952) 974-3201 Get Directions Write a Review

NPPES record last updated: March 23, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Nicole J Charles Pac NPPES

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

NICOLE J CHARLES PAC (NPI 1104008093) is an individual medical provider in Waconia, Minnesota, licensed in Minnesota (1081) and active in the NPI registry since December 2007. She is enrolled in Medicare PECOS, is affiliated with Ridgeview Medical Center, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1104008093

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameNICOLE J CHARLESCredential: PAC

Location Address500 S MAPLE STWaconia, MN 55387-1752

Mailing Address4729 County Road 101Minnetonka, MN 55345-2634 · (952) 974-3200 · Fax (952) 974-3201

Phone(952) 442-2191

Fax(952) 974-3201

Sole ProprietorNo

Medical School CMSOtherGraduated 2007

Enumeration DateDecember 3, 2007

Last NPPES UpdateMarch 23, 2021

NPPES CertifiedMarch 23, 2021

✔ NPI 1104008093 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in MN · 1081

500 S MAPLE ST, Waconia, MN 55387

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Other Identifiers 1

Other1081MN · Mn Registration

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.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 J Charles Pac 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 ID749361434

PECOS Enrollment IDI20080119000009

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 5

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.

99 services62 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

70 services35 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

63 services37 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

40 services40 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

24 services24 patients

Hospital Affiliations CMS Care Compare 3

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

Ridgeview Medical Center

Acute Care Hospitals · Waconia, MN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240056

Location500 South Maple StreetWaconia, MN 55387 · Carver County

Emergency services Birthing friendly

Ridgeview Sibley Medical Center

Critical Access Hospitals · Arlington, MN

OwnershipVoluntary non-profit - Private

CMS Certification Number241311

Location601 West ChandlerArlington, MN 55307 · Sibley County

Emergency services

Minnesota Valley Health Center Inc

Critical Access Hospitals · Le Sueur, MN

OwnershipVoluntary non-profit - Private

CMS Certification Number241375

Location621 South Fourth StreetLe Sueur, MN 56058 · Le Sueur County

Emergency services

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier14 claims14 services$3.14 avg. paid by Medicare

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

DME-Oxygen and Supplies · category DC002N

1 supplier32 claims32 services$80.49 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier18 claims18 services$35.73 avg. paid by Medicare

Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$29.57 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 20

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

MR. JEFFREY DUANE MARTIN CRNA

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