PAUL NIEDBALA
NPI 1194474122
Nurse Practitioner - Family in Pawcatuck, CT

Active since March 18, 2022PECOS EnrolledAccepts Medicare Assignment
93.27/100
CMS Quality Rating
91 VOLUNTOWN RD, PAWCATUCK, CT 06379(860) 599-5477 Get Directions Write a Review

NPPES record last updated: March 18, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Paul Niedbala NPPES

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

PAUL NIEDBALA (NPI 1194474122) is an individual family provider in Pawcatuck, Connecticut, licensed in Connecticut (10296) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS, is affiliated with Westerly Hospital, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1194474122
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NamePAUL NIEDBALA
Location Address91 VOLUNTOWN RDPawcatuck, CT 06379-1389
Mailing Address11 Banker CtPawcatuck, CT 06379-1345 · (860) 235-0347
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateMarch 18, 2022
NPPES CertifiedMarch 18, 2022
NPI 1194474122 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in CT · 10296
91 VOLUNTOWN RD, Pawcatuck, CT 06379

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

Paul Niedbala 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 ID5597152017
PECOS Enrollment IDI20220429001845
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 8

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 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.
439 services382 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
94 services94 patients
Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected 0241U
This test detects the RNA of respiratory viruses, including COVID-19, Influenza A, Influenza B, and Respiratory Syncytial Virus, in an upper respiratory specimen. The test result will report if each virus is detected or not, helping in accurate diagnosis.
70 services68 patients
Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
47 services43 patients
Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique 87651
This test detects Group A Streptococcus bacteria in your body. It uses an amplified probe technique, which amplifies the bacteria's nucleic acid, making it easier to identify. This test helps diagnose conditions like strep throat or scarlet fever.
29 services28 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
29 services28 patients

Hospital Affiliations CMS Care Compare

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

Westerly Hospital

Acute Care Hospitals · Westerly, RI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number410013
Location25 Wells StreetWesterly, RI 02891 · Washington County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06379 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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.

93.27/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality81.72
Promoting Interoperability78.03
Improvement Activities40

Other Providers at the Same Location NPPES 8

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

Physician Assistant
91 VOLUNTOWN RD
PAWCATUCK, CT 06379
Family Medicine
91 VOLUNTOWN RD
PAWCATUCK, CT 06379
Internal Medicine (Endocrinology, Diabetes & Metabolism)
91 VOLUNTOWN RD
PAWCATUCK, CT 06379
Family Medicine
91 VOLUNTOWN RD
PAWCATUCK, CT 06379
Internal Medicine
91 VOLUNTOWN RD
PAWCATUCK, CT 06379
Nurse Practitioner
91 VOLUNTOWN RD, NEMG YALE NEW HAVEN HOSPITAL
PAWCATUCK, CT 06379
Physician Assistant
91 VOLUNTOWN RD
PAWCATUCK, CT 06379
Nurse Practitioner (Family)
91 VOLUNTOWN RD
PAWCATUCK, CT 06379

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 Paul Niedbala's NPI number?

The NPI number for Paul Niedbala is 1194474122. It was assigned to this individual provider in the NPPES registry on March 18, 2022.

Where is Paul Niedbala located?

Paul Niedbala practices at 91 Voluntown Rd, Pawcatuck, CT 06379. The listed phone number is (860) 599-5477.

What is Paul Niedbala's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Paul Niedbala enrolled in Medicare?

Yes. Paul Niedbala 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.

Is Paul Niedbala affiliated with any hospitals?

According to CMS data, Paul Niedbala is affiliated with Westerly Hospital.

When was this NPI record last updated?

The NPPES record for Paul Niedbala was last updated on March 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.