BENJAMIN NICHOLS
NPI 1407204811
Physician Assistant in Walla Walla, WA

Q: What is Benjamin Nichols's NPI number?

The NPI number for Benjamin Nichols is 1407204811. It was assigned to this individual provider in the NPPES registry on May 25, 2016.

Q: What is Benjamin Nichols's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Benjamin Nichols was last updated on March 22, 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.

Active since May 25, 2016PECOS EnrolledAccepts Medicare Assignment

1120 W ROSE ST, WALLA WALLA, WA 99362(509) 525-6650(509) 522-2349 Get Directions Write a Review

NPPES record last updated: March 22, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 22, 2021, Nov 16, 2016 (2 updates tracked since 2016).

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About Benjamin Nichols NPPES

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

BENJAMIN NICHOLS (NPI 1407204811) is an individual physician assistant in Walla Walla, Washington, licensed in Washington (PA60694546) and active in the NPI registry since May 2016. He is enrolled in Medicare PECOS, is affiliated with Providence St Mary Medical Center, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1407204811

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameBENJAMIN NICHOLS

Location Address1120 W ROSE STWalla Walla, WA 99362-1662

Mailing Address1120 W Rose StWalla Walla, WA 99362-1662 · (509) 525-6650 · Fax (509) 522-2349

Phone(509) 525-6650

Fax(509) 522-2349

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateMay 25, 2016

Last NPPES UpdateMarch 22, 20212 updates tracked since enumeration

NPPES CertifiedMarch 22, 2021

✔ NPI 1407204811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in WA · PA60694546

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1120 W ROSE ST, Walla Walla, WA 99362

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska and more.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

Benjamin Nichols 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 ID9537449715

PECOS Enrollment IDI20161205001172

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.

Hospital Affiliations CMS Care Compare

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

Providence St Mary Medical Center

Acute Care Hospitals · Walla Walla, WA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500002

Location401 W Poplar StWalla Walla, WA 99362 · Walla Walla County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99362 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

$88.29 typical visit price

range $57.27 – $172.80

Typical copayment $22.07 (range $14.31 – $43.20)

Most-billed visit code 99203

Established Patient

$71.29 typical visit price

range $18.56 – $141.11

Typical copayment $17.82 (range $4.64 – $35.27)

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.

Referred Medical Equipment & Supplies CMS DME claims 2

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

3 suppliers17 claims41 services$3.71 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers12 claims12 services$184.24 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 20

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

YAKIMA VALLEY FARM WORKERS CLINIC

Clinic/Center (Federally Qualified Health Center (FQHC))