1. Home
  2. Directory
  3. Maryland
  4. Churchton
  5. Social Worker
  6. NPI Profile

NYKENJI NICOLE FOGG LCSW-C
NPI 1164192068
Social Worker - Clinical in Churchton, MD

Active since September 14, 2021PECOS Enrolled
79.54/100
CMS Quality Rating
5881 SHADY SIDE RD, CHURCHTON, MD 20733(443) 822-7273 Get Directions Write a Review

NPPES record last updated: September 14, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Nykenji Nicole Fogg Lcsw-c NPPES

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

NYKENJI NICOLE FOGG LCSW-C (NPI 1164192068) is an individual clinical provider in Churchton, Maryland, licensed in Maryland (20525) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164192068
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameNYKENJI NICOLE FOGGCredential: LCSW-C
Location Address5881 SHADY SIDE RDChurchton, MD 20733-9637
Mailing AddressPo Box 296Edgewater, MD 21037-0296 · (202) 446-6207
Phone(443) 822-7273
Sole ProprietorYes
Enumeration DateSeptember 14, 2021
NPPES CertifiedSeptember 14, 2021
✔ NPI 1164192068 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MD · 20525
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
5881 SHADY SIDE RD, Churchton, MD 20733
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nykenji Nicole Fogg Lcsw-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Nykenji Fogg reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Luminis Health Medical Group, LLC
11 mi
Maternal & Fetal Medicine
185 HARRY S TRUMAN PKWY STE 120
Annapolis, MD 21401
  • Reassigned Medicare billing, District of Columbia enrollment
  • 336 clinicians in this Medicare group
NPI 1073580205 (410) 224-4442

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20733 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
$0.00 typical visit price
range $60.73 – $183.44
Typical copayment $0.00 (range $15.18 – $45.86)
Most-billed visit code NA
Established Patient
$75.47 typical visit price
range $19.60 – $149.17
Typical copayment $18.86 (range $4.90 – $37.29)
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.

79.54/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality69.02
Promoting Interoperability97
Improvement Activities40
Cost65.27

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 Nykenji Fogg's NPI number?

The NPI number for Nykenji Fogg is 1164192068. It was assigned to this individual provider in the NPPES registry on September 14, 2021.

Where is Nykenji Fogg located?

Nykenji Fogg practices at 5881 Shady Side Rd, Churchton, MD 20733. The listed phone number is (443) 822-7273.

What is Nykenji Fogg's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Nykenji Fogg enrolled in Medicare?

Yes. Nykenji Fogg is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Nykenji Fogg's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nykenji Fogg reassigns Medicare benefits to Luminis Health Medical Group, LLC (Annapolis, MD). The 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 Nykenji Fogg's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nykenji Fogg was last updated on September 14, 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.