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DR. NICOLE THEISS FOGWELL PHD
NPI 1396535894
Psychologist - Health in Miami, FL

Active since May 08, 2025PECOS EnrolledAccepts Medicare Assignment
1695 NW 9TH AVE STE 2416, MIAMI, FL 33136(440) 212-2384 Get Directions Write a Review

NPPES record last updated: May 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Nicole Theiss Fogwell Phd NPPES

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

DR. NICOLE THEISS FOGWELL PHD (NPI 1396535894) is an individual health provider in Miami, Florida and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1396535894
Entity TypeIndividualFemale
Primary Taxonomy103TH0004X
Provider Legal NameDR. NICOLE THEISS FOGWELLCredential: PHD
Location Address1695 NW 9TH AVE STE 2416Miami, FL 33136-1409
Mailing Address960 Sw 2nd St Apt 3Miami, FL 33130-1137 · (440) 212-2384
Phone(440) 212-2384
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateMay 8, 2025
NPPES CertifiedMay 8, 2025
✔ NPI 1396535894 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · HealthBehavioral Health & Social Service Providers
Taxonomy Code103TH0004X
Definition
A psychologist who specializes in clinical health psychology that investigates and implements clinical services across diverse populations and settings to promote health and well-being and to prevent, treat, and manage illness and disability. Clinical health psychology sees health as the confluence of psychological, social, cultural, and biological factors and applies this understanding to professional activities including:
1695 NW 9TH AVE STE 2416, Miami, FL 33136
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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

Dr. Nicole Theiss Fogwell Phd 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 ID4082104641
PECOS Enrollment IDI20251104000072
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.

Other Providers at the Same Location NPPES

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

DR. LEONARDO HIDALGO PSY.D, LCSW
Social Worker (Clinical)
1695 NW 9TH AVE STE 2416
MIAMI, FL 33136
Miami-Dade County (305) 355-8059

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 Fogwell's NPI number?

The NPI number for Nicole Fogwell is 1396535894. It was assigned to this individual provider in the NPPES registry on May 8, 2025.

Where is Nicole Fogwell located?

Nicole Fogwell practices at 1695 NW 9th Ave Ste 2416, Miami, FL 33136. The listed phone number is (440) 212-2384.

What is Nicole Fogwell's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Health, with taxonomy code 103TH0004X.

Is Nicole Fogwell enrolled in Medicare?

Yes. Nicole Fogwell 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.

When was this NPI record last updated?

The NPPES record for Nicole Fogwell was last updated on May 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.