DR. NICOLA W GATHAIYA MD
NPI 1154513752
Internal Medicine - Endocrinology, Diabetes & Metabolism in Springfield, MO

Q: What is Nicola Gathaiya's NPI number?

The NPI number for Nicola Gathaiya is 1154513752. It was assigned to this individual provider in the NPPES registry on August 16, 2007. The provider is also known as Nicola W Mwirigi M.B.B.S..

Q: What is Nicola Gathaiya's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Q: When was this NPI record last updated?

The NPPES record for Nicola Gathaiya was last updated on March 7, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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 August 16, 2007PECOS EnrolledAccepts Medicare Assignment

960 E. WALNUT LAWN, SUITE 201, SPRINGFIELD, MO 65807(417) 269-4450(417) 269-8333 Get Directions Write a Review

NPPES record last updated: March 7, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Nicola W Gathaiya Md NPPES

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

DR. NICOLA W GATHAIYA MD (NPI 1154513752) is an individual endocrinology, diabetes & metabolism provider in Springfield, Missouri, licensed in Missouri (2013003418) and active in the NPI registry since August 2007. She is enrolled in Medicare PECOS, is affiliated with Cox Medical Centers, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1154513752

Entity TypeIndividualFemale

Primary Taxonomy207RE0101X

Provider Legal NameDR. NICOLA W GATHAIYACredential: MD

Location Address960 E. WALNUT LAWN, SUITE 201Springfield, MO 65807

Mailing Address960 E. Walnut Lawn, Suite 201Springfield, MO 65807 · (417) 269-4450 · Fax (417) 269-8333

Phone(417) 269-4450

Fax(417) 269-8333

Sole ProprietorNo

Medical School CMSOtherGraduated 2005

Enumeration DateAugust 16, 2007

Last NPPES UpdateMarch 7, 2013

✔ NPI 1154513752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians

Taxonomy Code207RE0101X

Licenses✔ Licensed in MO · 2013003418✔ Licensed in MN · 51914

Definition

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

960 E. WALNUT LAWN, Springfield, MO 65807

Open in Google Maps ↗

Other Names 1

Former Name (1)Nicola W Mwirigi M.b.b.s.

Other Identifiers 4

MedicaidENROLLEDIA

MedicaidENROLLEDMN

Medicare PIN110013090MN

OtherP00864005MN · Medicare Railroad

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Cox HealthPlans, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Nicola W Gathaiya Md 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 ID9032259791

PECOS Enrollment IDI20130812000263

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.

Medicare Billing Reassignments

Medicare enrollment records show Nicola Gathaiya reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lester E Cox Medical Centers

Same address

Internal Medicine

960 E WALNUT LAWN ST, STE. 201
Springfield, MO 65807

Reassigned Medicare billing, Missouri enrollment
24 clinicians in this Medicare group

NPI 1164595153 (417) 269-4450

Lester E Cox Medical Centers

0.1 mi

Geriatric Medicine

3525 S NATIONAL AVE STE 205A
Springfield, MO 65807

Reassigned Medicare billing, Missouri enrollment
457 clinicians in this Medicare group

NPI 1114953510 (417) 269-9714

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 25

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.

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

332 services233 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.

207 services197 patients

Blood test, thyroid stimulating hormone (tsh) 84443

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

194 services152 patients

Ultrasound scan of head and neck soft tissue 76536

An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.

115 services114 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.

92 services89 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.

86 services86 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

77 services66 patients

Dxa bone density measurement of hip, pelvis, spine 77080

A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.

74 services74 patients

Blood test, comprehensive group of blood chemicals 80053

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

69 services63 patients

Fine needle aspiration biopsy using ultrasound guidance, first growth 10005

Fine needle aspiration biopsy with ultrasound guidance is a procedure where a thin needle is inserted into a growth to extract a small sample. Ultrasound helps accurately locate the growth. This sample is then analyzed to determine the nature of the growth.

59 services49 patients

Thyroid hormone, t3 measurement, free 84481

The T3 measurement, free, is a blood test that checks the level of a hormone called triiodothyronine. This hormone is produced by your thyroid, a small gland in your neck. It plays a key role in regulating your body's metabolism and energy use.

55 services43 patients

Thyroxine (thyroid chemical), free 84439

The Thyroxine (thyroid chemical), free test is a blood test that measures the level of free T4 in your body. T4 is a hormone produced by your thyroid gland and is essential for growth and metabolism. If your T4 levels are too high or too low, it could indicate a thyroid disorder.

54 services42 patients

Interpretation of trabecular bone score (tbs) and report on fracture risk 77092

The Trabecular Bone Score (TBS) is a tool that helps evaluate your bone health. It looks at the texture of your bones, which can indicate their strength. The results, combined with other tests, help assess your risk of future fractures.

34 services34 patients

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251

This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.

31 services29 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.

30 services20 patients

Calculation of trabecular bone score (tbs) using imaging data with interpretation and report on fracture risk 77089

Trabecular Bone Score (TBS) is a technique that uses imaging data to evaluate bone texture. It provides insight into bone strength, helping predict fracture risk. This information is then compiled into a report to aid in your bone health management.

24 services24 patients

Blood test, basic group of blood chemicals (calcium, total) 80048

A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.

23 services23 patients

Blood test, lipids (cholesterol and triglycerides) 80061

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

19 services18 patients

Creatinine level to test for kidney function or muscle injury 82570

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

18 services18 patients

Urine microalbumin (protein) level 82043

The urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.

17 services17 patients

Cortisol (hormone) measurement, total 82533

Cortisol measurement is a test that checks the level of cortisol, a hormone, in your body. It's often used to assess stress levels or check for conditions like Addison's disease or Cushing's syndrome. This involves a simple blood or saliva sample.

17 services15 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

17 services14 patients

Calcium level, total 82310

A total calcium level test measures the amount of calcium in your blood. Calcium is essential for body functions like bone formation, nerve signal transmission, and muscle contraction. Abnormal levels may indicate conditions like bone disease or kidney disorders.

16 services14 patients

Fine needle aspiration biopsy using ultrasound guidance, each additional growth 10006

A fine needle aspiration biopsy with ultrasound guidance is a procedure where a thin needle is used to collect cells from a growth. Ultrasound helps accurately locate the growth. If there's more than one growth, each one is biopsied separately.

15 services14 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

13 services13 patients

Hospital Affiliations CMS Care Compare 3

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

Cox Medical Centers

Acute Care Hospitals · Springfield, MO

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260040

Location3801 South National AvenueSpringfield, MO 65807 · Greene County

Emergency services Birthing friendly

Cox Medical Center Branson

Acute Care Hospitals · Branson, MO

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260094

Location525 Branson Landing Blvd, PO Box 650Branson, MO 65615 · Taney County

Emergency services Birthing friendly

Cox Monett Hospital

Critical Access Hospitals · Monett, MO

OwnershipVoluntary non-profit - Private

CMS Certification Number261329

Location1000 E Us Highway 60Monett, MO 65708 · Barry County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65807 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

$121.96 typical visit price

range $52.28 – $161.24

Typical copayment $30.49 (range $13.07 – $40.31)

Most-billed visit code 99204

Established Patient

$93.24 typical visit price

range $16.30 – $131.05

Typical copayment $23.31 (range $4.07 – $32.76)

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.

Referred Medical Equipment & Supplies CMS DME claims 7

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

Supplies for maintenance of insulin infusion catheter, per week A4224

DME-Other DME · category DE017N

3 suppliers21 claims272 services$18.31 avg. paid by Medicare

Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225

DME-Other DME · category DE017N

3 suppliers21 claims730 services$2.37 avg. paid by Medicare

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

22 suppliers62 claims280 services$6.55 avg. paid by Medicare

Normal, low and high calibrator solution / chips A4256

DME-Other DME · category DE000N

4 suppliers23 claims23 services$2.91 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

7 suppliers30 claims69 services$1.22 avg. paid by Medicare

External ambulatory infusion pump, insulin E0784

DME-Other DME · category DE017N

3 suppliers32 claims32 services$300.93 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 2

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

DR. GLENN A GERON DO

Family Medicine

960 E. WALNUT LAWN, SUITE 201
SPRINGFIELD, MO 65807

Greene County (417) 269-4450

MRS. DANIELLE R. BRADEN-MOLL RD, LD, CDE

Dietitian, Registered

960 E. WALNUT LAWN, SUITE 201
SPRINGFIELD, MO 65807

Greene County (417) 269-4450

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 Nicola Gathaiya's NPI number?

The NPI number for Nicola Gathaiya is 1154513752. It was assigned to this individual provider in the NPPES registry on August 16, 2007. The provider is also known as Nicola W Mwirigi M.B.B.S..

Where is Nicola Gathaiya located?

Nicola Gathaiya practices at 960 E. Walnut Lawn Suite 201, Springfield, MO 65807. The listed phone number is (417) 269-4450.

What is Nicola Gathaiya's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Nicola Gathaiya enrolled in Medicare?

Yes. Nicola Gathaiya 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.

Which organizations bill Medicare for Nicola Gathaiya's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicola Gathaiya reassigns Medicare benefits to 2 organizations: Lester E Cox Medical Centers (Springfield, MO) and Lester E Cox Medical Centers (Springfield, MO). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicola Gathaiya's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nicola Gathaiya accept?

Health plans from Anthem Blue Cross and Blue Shield, Cox HealthPlans and Oscar Insurance Company list Nicola Gathaiya 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 Nicola Gathaiya affiliated with any hospitals?

According to CMS data, Nicola Gathaiya is affiliated with Cox Medical Centers, Cox Medical Center Branson and Cox Monett Hospital.

When was this NPI record last updated?

The NPPES record for Nicola Gathaiya was last updated on March 7, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.