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NICOLE J HEISMAN-RIFKIN DO
NPI 1154301927
Internal Medicine in Stowe, PA

Active since January 18, 2006PECOS EnrolledAccepts Medicare Assignment
78.36/100
CMS Quality Rating
555 GLASGOW ST, STOWE, PA 19464(484) 945-0770(484) 945-0648 Get Directions Write a Review

NPPES record last updated: November 16, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Nicole J Heisman-rifkin Do NPPES

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

NICOLE J HEISMAN-RIFKIN DO (NPI 1154301927) is an individual internal medicine provider in Stowe, Pennsylvania, licensed in Pennsylvania (OS012032) and active in the NPI registry since January 2006. She is enrolled in Medicare PECOS, is affiliated with Reading Hospital, and is a graduate of Philadelphia College Of Osteopathic Medicine (2000).

NPPES Registry Identity

NPI1154301927
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameNICOLE J HEISMAN-RIFKINCredential: DO
Location Address555 GLASGOW STStowe, PA 19464-6557
Mailing Address305 Second Ave, Marketplace At CollegevilleCollegeville, PA 19426-2658 · (484) 961-8220 · Fax (484) 961-8230
Phone(484) 945-0770
Fax(484) 945-0648
Sole ProprietorNo
Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 2000
Enumeration DateJanuary 18, 2006
Last NPPES UpdateNovember 16, 2016
✔ NPI 1154301927 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in PA · OS012032
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
555 GLASGOW ST, Stowe, PA 19464
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Other Names 1

Other Name (5)Nicole J Heisman Do

Other Identifiers 3

Medicare PINP00049998
Medicare UPINH86722
Medicare ID-Type Unspecified070675

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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 Heisman-rifkin Do 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 ID2365587243
PECOS Enrollment IDI20100303000335
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 10

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.
459 services232 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.
174 services130 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
155 services155 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
57 services56 patients
Transitional care management services for problem of high complexity 99496
Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.
28 services22 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
26 services26 patients

Hospital Affiliations CMS Care Compare 4

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

Reading Hospital

Acute Care Hospitals · West Reading, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390044
Location420 S 5th AvenueWest Reading, PA 19611 · Berks County
Emergency services Birthing friendly

Pottstown Hospital

Acute Care Hospitals · Pottstown, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390123
Location1600 East High StreetPottstown, PA 19464 · Montgomery County
Emergency services

Phoenixville Hospital

Acute Care Hospitals · Phoenixville, PA
3/5 CMS rating
OwnershipProprietary
CMS Certification Number390127
Location140 Nutt RoadPhoenixville, PA 19460 · Chester County
Emergency services Birthing friendly

Paoli Hospital

Acute Care Hospitals · Paoli, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390153
Location255 West Lancaster AvenuePaoli, PA 19301 · Chester County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19464 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
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
Most-billed visit code 99214
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.

78.36/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.13
Promoting Interoperability98
Improvement Activities40
Cost48.42

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
49%239 patients3/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
52%368 patients3/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
22%60 patients1/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%2,124 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
99%3,162 patients5/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
28%664 patients2/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%223 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
79%795 patients4/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
29%787 patients2/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 99% · 620 patients
Patients tobacco: 19% · 37 patients
93%620 patients4/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%795 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
18%795 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
45%795 patients
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.

Referred Medical Equipment & Supplies CMS DME claims

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
8 suppliers20 claims48 services$6.73 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 5

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

MBETTIE WORRELL R.N.
Nurse Practitioner (Family)
555 GLASGOW ST
STOWE, PA 19464
Montgomery County (484) 945-0770
TRACEY L GEMZIK PA-C
Physician Assistant
555 GLASGOW ST
STOWE, PA 19464
Montgomery County (484) 945-0770
BRITTANY KERSHAW PA-C
Physician Assistant
555 GLASGOW ST
STOWE, PA 19464
Montgomery County (484) 945-0770
CORNELIUS MARVIN GEISSEN DO
Family Medicine
555 GLASGOW ST
STOWE, PA 19464
Montgomery County (484) 945-0770
AMY E HULL CRNP
Nurse Practitioner (Adult Health)
555 GLASGOW ST
POTTSTOWN, PA 19464
Montgomery County (484) 945-0770

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 Nicole Heisman-rifkin's NPI number?

The NPI number for Nicole Heisman-rifkin is 1154301927. It was assigned to this individual provider in the NPPES registry on January 18, 2006. The provider is also known as Nicole J Heisman Do.

Where is Nicole Heisman-rifkin located?

Nicole Heisman-rifkin practices at 555 Glasgow St, Stowe, PA 19464. The listed phone number is (484) 945-0770.

What is Nicole Heisman-rifkin's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Nicole Heisman-rifkin enrolled in Medicare?

Yes. Nicole Heisman-rifkin is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Nicole Heisman-rifkin accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Nicole Heisman-rifkin 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.

Is Nicole Heisman-rifkin affiliated with any hospitals?

According to CMS data, Nicole Heisman-rifkin is affiliated with Reading Hospital, Pottstown Hospital, Phoenixville Hospital and Paoli Hospital.

When was this NPI record last updated?

The NPPES record for Nicole Heisman-rifkin was last updated on November 16, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.