NICOLE ENGLERT PA-C
NPI 1104993674
Physician Assistant - Medical in Peoria, AZ

NPI Status: Active since November 29, 2006

Contact Information

13965 N 75TH AVE
PEORIA, AZ
ZIP 85381
Phone: (602) 843-2991
Fax: (602) 978-1226

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  • Individual
  • Female
  • Years of Experience 28
  • Physician Assistant
  • Medical
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About NICOLE ENGLERT

This page provides the complete NPI Profile along with additional information for Nicole Englert, a primary care provider established in Peoria, Arizona with a medical specialization in Physician Assistant, focusing in medical and more than 28 years of experience. The healthcare provider is registered in the NPI registry with number 1104993674 assigned on November 2006. The practitioner's primary taxonomy code is 363AM0700X with license number 2210 (AZ). The provider is registered as an individual and her NPI record was last updated 7 years ago.

NPI
1104993674
Provider Name
NICOLE ENGLERT PA-C
Other Name
NICOLE SHIREMAN PA-C
Other Name Type
Other Name (5)
Gender
Female
Entity Type
Individual
Location Address
13965 N 75TH AVE PEORIA, AZ 85381
Location Phone
(602) 843-2991
Location Fax
(602) 978-1226
Mailing Address
13965 N 75TH AVE PEORIA, AZ 85381
Mailing Phone
(602) 843-2991
Mailing Fax
(602) 978-1226
Medical School Name
OTHER
Graduation Year
1998
Is Sole Proprietor?
No
Enumeration Date
11-29-2006
Last Update Date
06-27-2019
Code Navigator

A primary care provider (PCP) like Nicole Englert 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

Physician Assistant Medical

Taxonomy Code
363AM0700X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
2210
License State
AZ

Insurance Plans Accepted

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

  • AZ Blue AdvanceHealth Bronze Focus (4 Free PCP Visits) - HMO
  • AZ Blue AdvanceHealth Gold Focus (4 Free PCP Visits) - HMO
  • AZ Blue AdvanceHealth Silver Focus (4 Free PCP Visits) - HMO
  • AZ Blue EverydayHealth Gold Focus (1 Free PCP Visit) - HMO
  • AZ Blue EverydayHealth Prosano Gold ($0 Prosano Health Visits) - HMO
  • AZ Blue EverydayHealth Prosano Silver ($0 Prosano Health Visits) - HMO
  • AZ Blue EverydayHealth Silver Focus (1 Free PCP Visit) - HMO
  • AZ Blue Portfolio Bronze HSA Focus - HMO
  • AZ Blue StandardHealth Bronze Focus - HMO
  • AZ Blue StandardHealth Gold Focus - HMO
  • AZ Blue StandardHealth Silver Focus - HMO
  • Imperial Preferred Gold - HMO
  • Imperial Preferred Silver - HMO
  • Imperial Standard Bronze - HMO
  • Imperial Standard Gold - HMO
  • Imperial Standard Silver - HMO

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

Medicare Participation & PECOS Enrollment Status

Nicole Englert is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Nicole Englert 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

  • PECOS PAC ID: 7719064195

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20090414000445

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • 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

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 12 times for 12 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 41 times for 38 patients

Test to measure rate of airflow

This test, known as spirometry, measures how much air you can breathe in and out, and how quickly you can do so. It helps assess your lung function and can be used to diagnose or monitor conditions like asthma or COPD.

This service was performed 27 times for 27 patients

Reviews for NICOLE ENGLERT PA-C

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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 1104993674, we treat the final digit (4) 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 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

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
1
Unchanged
Pos 3
0
Doubled → 0
Pos 4
4
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
9
Unchanged
Pos 7
3
Doubled → 6
Pos 8
6
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
4
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 0 → 0 9 → 18 → 9 3 → 6 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 0 + 4 + 1 + 8 + 9 + 6 + 6 + 1 + 4 + 24 = 66

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

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1104993674.

Other Providers at the Same Location


The following 9 providers are registered at the same or a nearby location.

Allergy & Immunology
13965 N 75TH AVE
PEORIA, AZ 85381
Allergy & Immunology
13965 N 75TH AVE
PEORIA, AZ 85381
Physician Assistant
13965 N 75TH AVE
PEORIA, AZ 85381
Physician Assistant (Medical)
13965 N 75TH AVE
PEORIA, AZ 85381
Physician Assistant (Medical)
13965 N 75TH AVE
PEORIA, AZ 85381
Physician Assistant
13965 N 75TH AVE
PEORIA, AZ 85381
Allergy & Immunology
13965 N 75TH AVE
PEORIA, AZ 85381
Internal Medicine (Allergy & Immunology)
13965 N 75TH AVE
PEORIA, AZ 85381
Physician Assistant (Medical)
13965 N 75TH AVE
PEORIA, AZ 85381

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104993674, enumerated as an "individual" on November 29, 2006.

The provider is located at 13965 N 75TH AVE PEORIA, AZ 85381 and the phone number is (602) 843-2991.

Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.

The provider might be accepting Accepts: Blue Cross Blue Shield of Arizona and Imperial. Please consult your insurance carrier or call the provider to verify.