NICHOLAS D SOUSA D.O.
NPI 1134533912
Surgery in Madison Heights, MI

Q: What is Nicholas Sousa's NPI number?

The NPI number for Nicholas Sousa is 1134533912. It was assigned to this individual provider in the NPPES registry on June 19, 2014.

Q: What is Nicholas Sousa's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for Nicholas Sousa was last updated on September 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 June 19, 2014PECOS EnrolledAccepts Medicare Assignment

86.85/100

CMS Quality Rating

27483 DEQUINDRE RD STE 301, MADISON HEIGHTS, MI 48071(248) 546-2600 Get Directions Write a Review

NPPES record last updated: September 16, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 16, 2022, Aug 10, 2020, Jul 14, 2020 and 1 more (4 updates tracked since 2020).

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About Nicholas D Sousa D.o. NPPES

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

NICHOLAS D SOUSA D.O. (NPI 1134533912) is an individual surgery provider in Madison Heights, Michigan, licensed in Michigan (5101021243) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS, is affiliated with Lake Huron Medical Center, and is a graduate of Lake Erie College Of Osteopathic Medicine, Erie (2014).

NPPES Registry Identity

NPI1134533912

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameNICHOLAS D SOUSACredential: D.O.

Location Address27483 DEQUINDRE RD STE 301Madison Heights, MI 48071-5715

Mailing Address27483 Dequindre Rd Ste 301Madison Heights, MI 48071-5715 · (248) 546-2600 · Fax (248) 546-2604

Phone(248) 546-2600

Sole ProprietorYes

Medical School CMSLake Erie College Of Osteopathic Medicine, ErieGraduated 2014

Enumeration DateJune 19, 2014

Last NPPES UpdateSeptember 16, 20224 updates tracked since enumeration

NPPES CertifiedOctober 14, 2020

✔ NPI 1134533912 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in MI · 5101021243

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

27483 DEQUINDRE RD STE 301, Madison Heights, MI 48071

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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

Nicholas D Sousa D.o. 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 ID345549911

PECOS Enrollment IDI20190621001290

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 6

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.

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.

260 services147 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

151 services145 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.

58 services31 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

17 services15 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.

16 services13 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.

12 services12 patients

Hospital Affiliations CMS Care Compare 5

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

Lake Huron Medical Center

Acute Care Hospitals · Port Huron, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number230031

Location2601 Electric AvenuePort Huron, MI 48060 · St. Clair County

Emergency services

Promedica Monroe Regional Hospital

Acute Care Hospitals · Monroe, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number230099

Location718 N Macomb StMonroe, MI 48162 · Monroe County

Emergency services Birthing friendly

Ascension Macomb Oakland Hosp-Warren Campus

Acute Care Hospitals · Warren, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230195

Location11800 East Twelve Mile RoadWarren, MI 48093 · Macomb County

Emergency services

Mclaren Port Huron

Acute Care Hospitals · Port Huron, MI

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230216

Location1221 Pine Grove AvePort Huron, MI 48060 · St. Clair County

Emergency services Birthing friendly

Ascension Providence Rochester Hospital

Acute Care Hospitals · Rochester, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230254

Location1101 W University DriveRochester, MI 48307 · Oakland County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48071 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

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$72.38 typical visit price

range $18.32 – $143.49

Typical copayment $18.09 (range $4.58 – $35.87)

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.

86.85/100

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

Scored as part of a group practice

Quality

84.71

Promoting Interoperability

100

Improvement Activities

Cost

65.3

Reported Quality Measures

Breast Cancer Screening

24%102 patients2/55-star benchmark: 93%

Cervical Cancer Screening

20%394 patients1/55-star benchmark: 98%

Controlling High Blood Pressure

77%225 patients4/55-star benchmark: 91%

Diabetes: Eye Exam

7%81 patients1/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

73%81 patients2/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

100%849 patients5/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

88%515 patients4/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

70%366 patients3/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

39%520 patients3/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients screened: 29% · 379 patients

27%379 patients

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

28%352 patients1/55-star benchmark: 91%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 15

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

HANNAH TROYER

Surgery